Provider Demographics
NPI:1346946134
Name:WANLASS, RHIANNON (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:RHIANNON
Middle Name:
Last Name:WANLASS
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 S MEDICAL CENTER DR STE 320
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7266
Mailing Address - Country:US
Mailing Address - Phone:435-251-3950
Mailing Address - Fax:
Practice Address - Street 1:652 S MEDICAL CENTER DR STE 320
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7266
Practice Address - Country:US
Practice Address - Phone:435-251-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-02
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5646802-3102163W00000X
UT5646802-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse