Healthcare Provider Details

I. General information

NPI: 1447166459
Provider Name (Legal Business Name): TIFFANY LOTT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

968 CHAMBERS ST STE 5
OGDEN UT
84403-5082
US

IV. Provider business mailing address

2994 N MORNING MIST CT
PLAIN CITY UT
84404-4792
US

V. Phone/Fax

Practice location:
  • Phone: 801-605-3801
  • Fax:
Mailing address:
  • Phone: 801-726-1251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5908284-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: