Healthcare Provider Details

I. General information

NPI: 1144198185
Provider Name (Legal Business Name): SARAH ELIZABETH GRONEMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 E 1650 S
BOUNTIFUL UT
84010-1586
US

IV. Provider business mailing address

2637 N 400 E STE 164
NORTH OGDEN UT
84414-2240
US

V. Phone/Fax

Practice location:
  • Phone: 801-997-1276
  • Fax:
Mailing address:
  • Phone: 214-970-6817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8172806-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: