Healthcare Provider Details

I. General information

NPI: 1245904473
Provider Name (Legal Business Name): MELISSA ORTON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA NIELSEN

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
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

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

V. Phone/Fax

Practice location:
  • Phone: 801-581-2747
  • Fax:
Mailing address:
  • Phone: 801-581-2121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1971482
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number7944286-4405
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number7944286-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: