Healthcare Provider Details

I. General information

NPI: 1396555074
Provider Name (Legal Business Name): CAMI COPIER MARTIN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAMI COPIER

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 S 1000 E STE 125
PAYSON UT
84651-5593
US

IV. Provider business mailing address

1552 S 910 W
PAYSON UT
84651-3215
US

V. Phone/Fax

Practice location:
  • Phone: 801-465-2559
  • Fax: 801-798-8513
Mailing address:
  • Phone: 801-319-5368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number10382650-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: