MEDICARE: MS. ESTHER L KANNAPEL 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	201167-4405	UT
2	363LF0000X	Family Nurse Practitioner	201167-4405	UT

General Provider Information

NPI Number	:	1679523831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ESTHER L KANNAPEL APRN

Provider Business Mailing Address
First Line	:	127 S 500 E STE 600
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1971
Country	:	US
Telephone Number	:	801-587-6705
Fax Number	:	801-715-8228

Provider Business Practice Location Address
First Line	:	1950 CIRCLE OF HOPE
Second Line	:	CLINIC 2B
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84112-5550
Country	:	US
Telephone Number	:	801-585-0100
Fax Number	:	801-585-0721

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	10/29/2021

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