Provider Demographics
NPI:1538632070
Name:SAGE CREEK FAMILY HEALTH CARE
Entity type:Organization
Organization Name:SAGE CREEK FAMILY HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHELSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRINGHURST
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:801-420-1761
Mailing Address - Street 1:7515 S 5600 W
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-9738
Mailing Address - Country:US
Mailing Address - Phone:801-420-1761
Mailing Address - Fax:
Practice Address - Street 1:656 N MAIN ST STE 7
Practice Address - Street 2:
Practice Address - City:NEPHI
Practice Address - State:UT
Practice Address - Zip Code:84648-1124
Practice Address - Country:US
Practice Address - Phone:801-420-1761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontologyGroup - Single Specialty