Healthcare Provider Details

I. General information

NPI: 1174465793
Provider Name (Legal Business Name): TAELOR HILDEBRAND MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 E 12300 S UNIT 871
DRAPER UT
84020-7976
US

IV. Provider business mailing address

138 E 12300 S UNIT 871
DRAPER UT
84020-7976
US

V. Phone/Fax

Practice location:
  • Phone: 801-921-0828
  • Fax:
Mailing address:
  • Phone: 801-921-0828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12104004-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: