Provider Demographics
NPI:1518321702
Name:SOMMERS, WHITNEY
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:SOMMERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1055 N 500 W
Mailing Address - Street 2:ATTN CREDENTIALING
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-5379
Mailing Address - Country:US
Mailing Address - Phone:801-354-8225
Mailing Address - Fax:
Practice Address - Street 1:1055 N 500 W BLDG A
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3305
Practice Address - Country:US
Practice Address - Phone:801-429-0057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10837220-4405363LF0000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No101Y00000XBehavioral Health & Social Service ProvidersCounselor