Healthcare Provider Details

I. General information

NPI: 1407638588
Provider Name (Legal Business Name): HOLLY ZIERENBERG CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1248 E 90 N # 300
AMERICAN FORK UT
84003-2956
US

IV. Provider business mailing address

1151 ASPEN CIR
HEBER CITY UT
84032-1125
US

V. Phone/Fax

Practice location:
  • Phone: 801-756-9635
  • Fax:
Mailing address:
  • Phone: 928-607-9661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number7704244-4402
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number7704244
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: