Healthcare Provider Details

I. General information

NPI: 1932373396
Provider Name (Legal Business Name): STEVEN HAROLD OSTERGAARD FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N MEDICAL DR
SALT LAKE CITY UT
84113-1103
US

IV. Provider business mailing address

PO BOX 581289
SALT LAKE CITY UT
84158-1289
US

V. Phone/Fax

Practice location:
  • Phone: 801-662-1200
  • Fax:
Mailing address:
  • Phone: 801-587-7450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201650-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: