Healthcare Provider Details

I. General information

NPI: 1447996509
Provider Name (Legal Business Name): HEATHER KAY VIGIL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N MAIN ST STE 101
BOUNTIFUL UT
84010-6254
US

IV. Provider business mailing address

110 N MAIN ST STE 101
BOUNTIFUL UT
84010-6254
US

V. Phone/Fax

Practice location:
  • Phone: 801-874-2388
  • Fax:
Mailing address:
  • Phone: 801-874-2388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number13978047-4405
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13978047-4405
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number6226885-3102
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number13978047-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: