Healthcare Provider Details

I. General information

NPI: 1932826716
Provider Name (Legal Business Name): MEGAN REBECCA OUDEKERK MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5187 S ASCENSION WAY STE 200
MURRAY UT
84123-3012
US

IV. Provider business mailing address

5187 S ASCENSION WAY STE 200
MURRAY UT
84123-3012
US

V. Phone/Fax

Practice location:
  • Phone: 801-359-7400
  • Fax: 801-359-7404
Mailing address:
  • Phone: 180-135-9740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9647
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number142680034405
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number228785
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: