Provider Demographics
NPI:1073305975
Name:FREIRE DOS SANTOS, GLEYSON (RN)
Entity type:Individual
Prefix:
First Name:GLEYSON
Middle Name:
Last Name:FREIRE DOS SANTOS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1446 W 1250 S
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-6190
Mailing Address - Country:US
Mailing Address - Phone:509-715-9919
Mailing Address - Fax:
Practice Address - Street 1:1446 W 1250 S
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:UT
Practice Address - Zip Code:84663-6190
Practice Address - Country:US
Practice Address - Phone:509-715-9919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13223253-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse