Healthcare Provider Details

I. General information

NPI: 1407136823
Provider Name (Legal Business Name): BONNIE L STEFFENS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 01/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 S ARAPEEN DR
SALT LAKE CITY UT
84108-1218
US

IV. Provider business mailing address

PO BOX 413027
SALT LAKE CITY UT
84141-3027
US

V. Phone/Fax

Practice location:
  • Phone: 801-585-6387
  • Fax: 801-747-0798
Mailing address:
  • Phone: 801-213-3900
  • Fax: 801-263-0255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number339076-8900
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: