Gilsa Correa Diaz, RN

Individual provider Active NPI Registered Nurse · Hill Afb, UT

NPI 1295568756 · NPPES record last updated Aug 21, 2024

Key facts

NPI
1295568756
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
12764193-3102 (UT)
Practice address
7321 Balmer St BLDG 570
Hill Afb, UT 84056-5012
Phone
(801) 777-7027
Fax
(801) 586-7435
NPI assigned
Aug 21, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
12764193-3102UTMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 12764193-3102 UT Yes

Addresses

Primary practice location

7321 Balmer St BLDG 570
Hill Afb, UT 84056-5012

Mailing address

1633 24TH St
Ogden, UT 84401-3001
Phone (210) 241-6242

Other providers in Hill Afb, UT

All providers in Hill Afb, UT · Registered Nurse in Utah

Sources for this page

Verify at the official NPI Registry.