Healthcare Provider Details

I. General information

NPI: 1972317469
Provider Name (Legal Business Name): ASHLEY GREENHALGH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2433 W 2225 N
FARR WEST UT
84404-3787
US

IV. Provider business mailing address

2433 W 2225 N
FARR WEST UT
84404-3787
US

V. Phone/Fax

Practice location:
  • Phone: 714-716-9033
  • Fax:
Mailing address:
  • Phone: 714-716-9033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10933142-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: