Healthcare Provider Details

I. General information

NPI: 1255846424
Provider Name (Legal Business Name): APRIL CUNDALL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2017
Last Update Date: 12/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 S 900 E
SALT LAKE CITY UT
84117-7209
US

IV. Provider business mailing address

PO BOX 3299
CARSON CITY NV
89702-3299
US

V. Phone/Fax

Practice location:
  • Phone: 801-783-5011
  • Fax:
Mailing address:
  • Phone: 775-222-0042
  • Fax: 775-222-0042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8407610-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: