1528812526 NPI number — JENIFER D ROYLANCE-FRANCO CPSS

Table of content: JENIFER D ROYLANCE-FRANCO CPSS (NPI 1528812526)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528812526 NPI number — JENIFER D ROYLANCE-FRANCO CPSS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROYLANCE-FRANCO
Provider First Name:
JENIFER
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CPSS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROYLANCE
Provider Other First Name:
JENIFER
Provider Other Middle Name:
D
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1528812526
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/16/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1061
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEHI
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84043-1198
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-407-9998
Provider Business Mailing Address Fax Number:
385-354-6539

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3784 W VALLEY VIEW DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDAR HILLS
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84062-8085
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-407-9998
Provider Business Practice Location Address Fax Number:
385-354-6539
Provider Enumeration Date:
04/16/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 175T00000X , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)