Healthcare Provider Details

I. General information

NPI: 1942135231
Provider Name (Legal Business Name): NOAH JOHNSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6131 S STEEPLE CHASE LN
MURRAY UT
84121-2037
US

IV. Provider business mailing address

6131 S STEEPLE CHASE LN
MURRAY UT
84121-2037
US

V. Phone/Fax

Practice location:
  • Phone: 801-505-3486
  • Fax:
Mailing address:
  • Phone: 801-505-3486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number14294550-4901
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: