MEDICARE: ELLEN MARIE CHOI KAHN MSN-FNP

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	363LF0000X	Family Nurse Practitioner	16297280091	UT

General Provider Information

NPI Number	:	1629728001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN MARIE CHOI KAHN MSN-FNP

Provider Business Mailing Address
First Line	:	604 N 1300 W
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84116-3873
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3665 S 8400 W
Second Line	:
City	:	MAGNA
State	:	UT
Zip	:	84044-4907
Country	:	US
Telephone Number	:	801-250-9638
Fax Number	:

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

Provider Enumeration Date	:	03/28/2022
Last Update Date	:	12/08/2025

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