Healthcare Provider Details

I. General information

NPI: 1396675906
Provider Name (Legal Business Name): THRIVE AESTHETICS AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6405 S 3000 E STE 100
SALT LAKE CITY UT
84121-6975
US

IV. Provider business mailing address

6405 S 3000 E STE 100
SALT LAKE CITY UT
84121-6975
US

V. Phone/Fax

Practice location:
  • Phone: 801-209-7299
  • Fax: 801-999-5799
Mailing address:
  • Phone: 801-209-7299
  • Fax: 801-999-5799

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: LAUREN GRACE MUIR
Title or Position: OWNER & MEDICAL DIRECTOR
Credential: NP
Phone: 801-647-6471