Healthcare Provider Details

I. General information

NPI: 1427896083
Provider Name (Legal Business Name): MICHAEL CHRISTIAN WOODHEAD MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2024
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 W 4800 S
MURRAY UT
84107-3758
US

IV. Provider business mailing address

84 W 4800 S
MURRAY UT
84107-3758
US

V. Phone/Fax

Practice location:
  • Phone: 801-224-8800
  • Fax:
Mailing address:
  • Phone: 801-224-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11130758-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: