Healthcare Provider Details

I. General information

NPI: 1528894425
Provider Name (Legal Business Name): MOBILE NP MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3373 W DEE CIR
RIVERTON UT
84065-7206
US

IV. Provider business mailing address

3373 W DEE CIR
RIVERTON UT
84065-7206
US

V. Phone/Fax

Practice location:
  • Phone: 801-604-9524
  • Fax: 801-823-0259
Mailing address:
  • Phone: 801-604-9524
  • Fax: 801-823-0259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CAREN D EREKSON
Title or Position: NURSE PRACTITIONER
Credential: DNP, APRN
Phone: 801-604-9524