Basic Information
| Provider Information | |||||||||
| NPI: | 1366172751 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ULSH | ||||||||
| FirstName: | ALYSSA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1588 S 300 W | ||||||||
| Address2: | |||||||||
| City: | PERRY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 843024611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4357307353 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10 S 2000 E | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841125880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015813414 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2022 | ||||||||
| LastUpdateDate: | 06/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WM0705X | 10837256-3102 | UT | Y | Nursing Service Providers | Registered Nurse | Medical-Surgical |
No ID Information.