Healthcare Provider Details

I. General information

NPI: 1801116322
Provider Name (Legal Business Name): ASHLEY WESTPHAL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY PORTER WESTPHAL RN

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5373 S GREEN ST STE 400
MURRAY UT
84123-4740
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 833-442-2615
  • Fax:
Mailing address:
  • Phone:
  • Fax: 406-859-3011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number33668
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13960628-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: