Healthcare Provider Details

I. General information

NPI: 1477975159
Provider Name (Legal Business Name): ALFIE RAE SYMES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2014
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
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

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

V. Phone/Fax

Practice location:
  • Phone: 17-762-2220
  • Fax:
Mailing address:
  • Phone: 801-776-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6234357-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: