| NPI | 1255191672 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SHELLEY HALE-BYINGTON Authorized Official 801-796-2678  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family | 
| Enumeration Date | 2024-03-21 | 
| Last Update Date | 2024-04-22 |