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NPI Code Detail

MEDICARE: RYLEE RUNNELS MSN, APRN, FNP-C

MEDICARE: RYLEE RUNNELS MSN, APRN, FNP-C
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
1163W00000XRegistered Nurse9364086-3102UT
2363LF0000XFamily Nurse Practitioner9364086-4405UT

General Provider Information

NPI Number : 1578342069
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYLEE RUNNELS MSN, APRN, FNP-C
Provider Business Mailing Address
First Line : 425 S 100 W
Second Line :
City : LAYTON
State : UT
Zip : 84041-5356
Country : US
Telephone Number : 435-730-3274
Fax Number :
Provider Business Practice Location Address
First Line : 2121 N 1700 W
Second Line :
City : LAYTON
State : UT
Zip : 84041-8803
Country : US
Telephone Number : 801-773-4840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2023
Last Update Date : 04/22/2026

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