Healthcare Provider Details

I. General information

NPI: 1619295359
Provider Name (Legal Business Name): FIONA YING FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 11/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 S 3090 E SUITE 400
SALT LAKE CITY UT
84109
US

IV. Provider business mailing address

3300 S 3090 E SUITE 400
SALT LAKE CITY UT
84109
US

V. Phone/Fax

Practice location:
  • Phone: 801-864-0142
  • Fax:
Mailing address:
  • Phone: 801-864-0142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5038550-8900
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5038550-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: