Healthcare Provider Details

I. General information

NPI: 1639648660
Provider Name (Legal Business Name): MORGAN ANN BATEMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2018
Last Update Date: 11/27/2023
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 N TRIUMPH BLVD STE 100
LEHI UT
84043
US

IV. Provider business mailing address

1055 N 500 W ATTN: CREDENTIALING
PROVO UT
84604
US

V. Phone/Fax

Practice location:
  • Phone: 385-203-1215
  • Fax: 801-766-5792
Mailing address:
  • Phone: 801-354-8225
  • Fax: 801-418-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9037554-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: