Healthcare Provider Details

I. General information

NPI: 1922919620
Provider Name (Legal Business Name): MADISON LIN GUNTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 N MAIN ST STE 3
CEDAR CITY UT
84721-9812
US

IV. Provider business mailing address

5181 N MATHESON WAY
ENOCH UT
84721-4929
US

V. Phone/Fax

Practice location:
  • Phone: 435-867-1960
  • Fax: 833-764-6087
Mailing address:
  • Phone: 435-749-9225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12060474-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: