Provider Demographics
NPI:1265164040
Name:ALLRED, JOSIE (APRN)
Entity type:Individual
Prefix:
First Name:JOSIE
Middle Name:
Last Name:ALLRED
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3592 S 2175 E
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84109-2903
Mailing Address - Country:US
Mailing Address - Phone:385-321-0926
Mailing Address - Fax:
Practice Address - Street 1:1192 E DRAPER PKWY # 121
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9356
Practice Address - Country:US
Practice Address - Phone:801-830-9887
Practice Address - Fax:801-742-8381
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-29
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8267859-3102163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice