Provider Demographics
NPI:1558495309
Name:IHC HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:IHC HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:HITOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:NASHIYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:801-897-4070
Mailing Address - Street 1:6612 CEDAR HILL CT
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-5052
Mailing Address - Country:US
Mailing Address - Phone:801-897-4070
Mailing Address - Fax:
Practice Address - Street 1:3215 VALLEY ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-4217
Practice Address - Country:US
Practice Address - Phone:801-466-3102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5796226-8900261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care