Healthcare Provider Details

I. General information

NPI: 1104762459
Provider Name (Legal Business Name): NAOMI MENSAH-COKER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N MEDICAL DR
SALT LAKE CITY UT
84132-0001
US

IV. Provider business mailing address

13328 S MOORFIELD DR
HERRIMAN UT
84096-6700
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-2335
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9688588-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: