Healthcare Provider Details

I. General information

NPI: 1407780919
Provider Name (Legal Business Name): HAYDEN HALE PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 S MILLROCK DR STE 250
SALT LAKE CITY UT
84121-2331
US

IV. Provider business mailing address

6550 S MILLROCK DR STE 250
SALT LAKE CITY UT
84121-2331
US

V. Phone/Fax

Practice location:
  • Phone: 801-821-2781
  • Fax:
Mailing address:
  • Phone: 801-821-2781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number14197782-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: