Healthcare Provider Details

I. General information

NPI: 1639005804
Provider Name (Legal Business Name): HANNAH JOAN MENDENHALL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 E 12200 S STE 200
DRAPER UT
84020-9888
US

IV. Provider business mailing address

1078 W VISTA RIDGE DR
LEHI UT
84048-6424
US

V. Phone/Fax

Practice location:
  • Phone: 801-776-2220
  • Fax:
Mailing address:
  • Phone: 801-776-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0121X
TaxonomyPlastic Surgery Registered Nurse
License Number5124919-3102
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number5124919-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: