Healthcare Provider Details

I. General information

NPI: 1689398992
Provider Name (Legal Business Name): LAURA GAYLE HAYES APRN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 E 4500 S
MURRAY UT
84107-3957
US

IV. Provider business mailing address

3356 W 775 N
LAYTON UT
84041-8801
US

V. Phone/Fax

Practice location:
  • Phone: 801-900-3280
  • Fax: 801-931-2234
Mailing address:
  • Phone: 801-900-3280
  • Fax: 801-931-2234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6637919-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: