Healthcare Provider Details

I. General information

NPI: 1497726244
Provider Name (Legal Business Name): LINDA MARIE DENTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 S MAIN ST
SALT LAKE CITY UT
84101-3176
US

IV. Provider business mailing address

3683 MEADOW STREAM RD
SALT LAKE CITY UT
84119-4017
US

V. Phone/Fax

Practice location:
  • Phone: 801-539-7000
  • Fax: 801-539-7050
Mailing address:
  • Phone: 801-266-7024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number163714-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: