Healthcare Provider Details

I. General information

NPI: 1710525209
Provider Name (Legal Business Name): ALENA GALAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2019
Last Update Date: 06/02/2021
Certification Date: 06/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 N UNIVERSITY AVE STE 205
PROVO UT
84601-2801
US

IV. Provider business mailing address

10376 N TAMARACK WAY
CEDAR HILLS UT
84062-8696
US

V. Phone/Fax

Practice location:
  • Phone: 801-804-3166
  • Fax:
Mailing address:
  • Phone: 561-718-4246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number9313297
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number9313296
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9313297
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9313297
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12302586-8900
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: