Healthcare Provider Details
I. General information
NPI: 1265329387
Provider Name (Legal Business Name): ANNE-MARIE FOULGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/20/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3934 S 2300 E
SALT LAKE CITY UT
84124-2848
US
IV. Provider business mailing address
10433 S REDWOOD RD STE 2
SOUTH JORDAN UT
84095-8502
US
V. Phone/Fax
- Phone: 801-859-2663
- Fax:
- Phone: 801-260-1919
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 5366830-4405 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 5366830-4405 |
| License Number State | UT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: