Individual provider Active NPI

Gillean Gauvreau

  • Licensed Practical Nurse
  • Salt Lake City, UT
National Provider Identifier
1275901134
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
199795 Issued in TX
Practice address
5965 S 900 E
Salt Lake City, UT 84121-1720
Phone
(801) 263-7138
NPI assigned
Sep 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 199795 TX Primary

Addresses

Primary practice location

5965 S 900 E
Salt Lake City, UT 84121-1720

Mailing address

5965 S 900 E
Salt Lake City, UT 84121-1720
Phone (801) 263-7138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
199795TXMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1275901134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211720",
            "telephone_number": "801-263-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211720",
            "telephone_number": "801-263-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUVREAU",
        "first_name": "GILLEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "199795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.