Healthcare Provider Details

I. General information

NPI: 1790442564
Provider Name (Legal Business Name): LAURA BARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

389 S 900 E
SALT LAKE CITY UT
84102-2310
US

IV. Provider business mailing address

6613 S ELLERSTON DR
MURRAY UT
84123-4593
US

V. Phone/Fax

Practice location:
  • Phone: 385-282-2594
  • Fax: 385-282-2735
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8298026-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: