Healthcare Provider Details

I. General information

NPI: 1144315110
Provider Name (Legal Business Name): JOAN L HADLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 S 900 E SUITE 100
MURRAY UT
84117-5788
US

IV. Provider business mailing address

5005 S 900 E SUITE 100
MURRAY UT
84117-5788
US

V. Phone/Fax

Practice location:
  • Phone: 801-262-7566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number2105274405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: