Healthcare Provider Details

I. General information

NPI: 1932139482
Provider Name (Legal Business Name): DEBRA JO HAIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13222 TREE SPARROW DR STE R210
RIVERTON UT
84096-2889
US

IV. Provider business mailing address

1650 OSCEOLA DR
WEST PALM BEACH FL
33409-5038
US

V. Phone/Fax

Practice location:
  • Phone: 801-872-5516
  • Fax: 801-212-9942
Mailing address:
  • Phone: 561-803-8880
  • Fax: 877-409-1795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1818372
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number13421220-4405
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberC-APN.0103871-C-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: