MEDICARE: HEATHER CAMPBELL APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	1997684405	UT
2	363LF0000X	Family Nurse Practitioner	199768-4405	UT

General Provider Information

NPI Number	:	1427080670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER CAMPBELL APRN

Provider Business Mailing Address
First Line	:	3725 W 4100 SOUTH
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120
Country	:	US
Telephone Number	:	801-965-3600
Fax Number	:	801-965-3526

Provider Business Practice Location Address
First Line	:	3725 W 4100 SOUTH
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120
Country	:	US
Telephone Number	:	801-965-3600
Fax Number	:	801-965-3526

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	01/13/2026

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