Healthcare Provider Details

I. General information

NPI: 1366242307
Provider Name (Legal Business Name): HEATHER SUZANNE MYERS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98 N 1100 E STE 202
AMERICAN FORK UT
84003-2941
US

IV. Provider business mailing address

10376 N MORGAN BLVD
CEDAR HILLS UT
84062-8057
US

V. Phone/Fax

Practice location:
  • Phone: 801-492-2510
  • Fax:
Mailing address:
  • Phone: 801-592-3802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8568310-4405
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: