Healthcare Provider Details

I. General information

NPI: 1689362600
Provider Name (Legal Business Name): WHITNEY ROSE HARRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2023
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CIRCLE OF HOPE DR RM LL376
SALT LAKE CITY UT
84112-5550
US

IV. Provider business mailing address

2000 CIRCLE OF HOPE DR RM LL376
SALT LAKE CITY UT
84112-5550
US

V. Phone/Fax

Practice location:
  • Phone: 801-585-0255
  • Fax:
Mailing address:
  • Phone: 801-585-0255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number14288687-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR80074
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: