Provider Demographics
NPI:1790571206
Name:MUNSTER FARRAR, HILDA MIRANDA (UT000526110316)
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:MIRANDA
Last Name:MUNSTER FARRAR
Suffix:
Gender:
Credentials:UT000526110316
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 E TELEGRAPH ST LOT 62
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-2810
Mailing Address - Country:US
Mailing Address - Phone:435-862-9120
Mailing Address - Fax:
Practice Address - Street 1:1360 E TELEGRAPH ST LOT 62
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-2810
Practice Address - Country:US
Practice Address - Phone:435-862-9120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-19
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTUT000526110316374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide