Healthcare Provider Details

I. General information

NPI: 1093239428
Provider Name (Legal Business Name): MOLLY WALKER BECK DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY WALKER ENGLISH

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 S ARAPEEN DR
SALT LAKE CITY UT
84108-1223
US

IV. Provider business mailing address

2219 E WILSON AVE
SALT LAKE CITY UT
84108-3023
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-3834
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number7992941-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: