Healthcare Provider Details

I. General information

NPI: 1932970761
Provider Name (Legal Business Name): MARIE HART CLAYTON MSN, RN, CCEP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3848 HARRISON BLVD
OGDEN UT
84408-0001
US

IV. Provider business mailing address

1924 W JOSEPH ACRES RD
KAYSVILLE UT
84037-4817
US

V. Phone/Fax

Practice location:
  • Phone: 801-626-6000
  • Fax:
Mailing address:
  • Phone: 801-682-3676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSTUDENT
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5033019-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: