Provider Demographics
NPI:1235661265
Name:LEMM, ALLISON
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:LEMM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4473 W 13400 N
Mailing Address - Street 2:
Mailing Address - City:CORNISH
Mailing Address - State:UT
Mailing Address - Zip Code:84308-1743
Mailing Address - Country:US
Mailing Address - Phone:435-213-3123
Mailing Address - Fax:
Practice Address - Street 1:4473 W 13400 N
Practice Address - Street 2:
Practice Address - City:CORNISH
Practice Address - State:UT
Practice Address - Zip Code:84308-1743
Practice Address - Country:US
Practice Address - Phone:435-213-3123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT365542-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse