Healthcare Provider Details

I. General information

NPI: 1346160900
Provider Name (Legal Business Name): GRETCHEN NICOLE COLBORN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3668 W 2150 N STE 100
LEHI UT
84048-7798
US

IV. Provider business mailing address

396 N OSIER AVE
LEHI UT
84043-6053
US

V. Phone/Fax

Practice location:
  • Phone: 801-922-9222
  • Fax: 801-766-5938
Mailing address:
  • Phone: 801-922-9222
  • Fax: 801-766-5938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number5253420-3120
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: