Healthcare Provider Details

I. General information

NPI: 1164346730
Provider Name (Legal Business Name): ANNIKA SLATER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 N ORCHARD DR
LEHI UT
84048-6430
US

IV. Provider business mailing address

564 N ORCHARD DR
LEHI UT
84048-6430
US

V. Phone/Fax

Practice location:
  • Phone: 801-369-6586
  • Fax:
Mailing address:
  • Phone: 801-369-6586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number7973809-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: