Healthcare Provider Details

I. General information

NPI: 1649146234
Provider Name (Legal Business Name): WELLMIND HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 S OREM BLVD STE 102
OREM UT
84058-3102
US

IV. Provider business mailing address

485 S OREM BLVD STE 102
OREM UT
84058-3102
US

V. Phone/Fax

Practice location:
  • Phone: 801-669-6889
  • Fax:
Mailing address:
  • Phone: 801-669-6889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHRISTOPHER MOORE
Title or Position: ADMIN
Credential:
Phone: 801-669-6889