Healthcare Provider Details

I. General information

NPI: 1770298309
Provider Name (Legal Business Name): LESLEY HEMPHILL DNP, MS, FNP-C, CHES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1784 UINTA WAY # WA
PARK CITY UT
84098-7669
US

IV. Provider business mailing address

1784 UINTA WAY UNIT E2
PARK CITY UT
84098-7685
US

V. Phone/Fax

Practice location:
  • Phone: 435-604-0160
  • Fax:
Mailing address:
  • Phone: 435-604-0160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4901790-4405
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06240096
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4901790-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: