Healthcare Provider Details

I. General information

NPI: 1508703968
Provider Name (Legal Business Name): NOAH CHESLEY RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5280 S COMMERCE DR STE E160
MURRAY UT
84107-5327
US

IV. Provider business mailing address

5280 S COMMERCE DR STE E160
MURRAY UT
84107-5327
US

V. Phone/Fax

Practice location:
  • Phone: 801-364-4250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number13177435-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: