Healthcare Provider Details

I. General information

NPI: 1174497325
Provider Name (Legal Business Name): MELISSA CAMILLE HANNI-SMITH DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 E HIGHWAY 193 STE C1
LAYTON UT
84040-8547
US

IV. Provider business mailing address

1525 E CANYON DR
SOUTH WEBER UT
84405-9220
US

V. Phone/Fax

Practice location:
  • Phone: 801-821-2254
  • Fax:
Mailing address:
  • Phone: 801-940-4161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11649149-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: