Basic Information
| Provider Information | |||||||||
| NPI: | 1710920566 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | FAUST | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | PNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 CHIPETA WAY | ||||||||
| Address2: | |||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015873102 | ||||||||
| FaxNumber: | 8015873100 | ||||||||
| Practice Location | |||||||||
| Address1: | 650 KOMAS DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841081229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015815515 | ||||||||
| FaxNumber: | 8015818979 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2006 | ||||||||
| LastUpdateDate: | 10/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 3121334405 | UT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.