Active NPI
Kelly Lynn Lance, APRN
- Family Nurse Practitioner
- Draper, UT
National Provider Identifier
1457603466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 214109-4405
- Practice address
- 248 E 13800 S
Suite 3
Draper, UT 84020-5010 - Phone
- (801) 987-8384
- NPI assigned
- Oct 15, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 214109-4405 | UT | Primary |
Addresses
Primary practice location
248 E 13800 S
Suite 3
Draper, UT 84020-5010
Mailing address
248 E 13800 S
Suite 3
Draper, UT 84020-5010
Phone (801) 987-8384
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
| License | State | Type | Specialty |
|---|---|---|---|
| 214109-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Belle Vie Medical Care and Aesthetics | Family | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Nurse Practitioner
- Draper, UT
- NPI 1639592611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416268800000",
"number": "1457603466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "248 E 13800 S",
"address_2": "SUITE 3",
"city": "DRAPER",
"state": "UT",
"postal_code": "840205010",
"telephone_number": "801-987-8384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "248 E 13800 S",
"address_2": "SUITE 3",
"city": "DRAPER",
"state": "UT",
"postal_code": "840205010",
"telephone_number": "801-987-8384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANCE",
"first_name": "KELLY",
"middle_name": "LYNN",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-15",
"last_updated": "2014-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "UT",
"license": "214109-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.