Healthcare Provider Details

I. General information

NPI: 1629998711
Provider Name (Legal Business Name): ABBEY COLLEEN WOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 N MILLER CAMPUS DR
LEHI UT
84048-7233
US

IV. Provider business mailing address

2255 GREENS LN
SPANISH FORK UT
84660-9599
US

V. Phone/Fax

Practice location:
  • Phone: 385-531-1000
  • Fax:
Mailing address:
  • Phone: 208-640-0314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number93935523102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: