Healthcare Provider Details

I. General information

NPI: 1043086747
Provider Name (Legal Business Name): THERESA BROOKE SLIGTING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9600 S 1300 E STE 220
SANDY UT
84094-3783
US

IV. Provider business mailing address

3080 E GRANITE SLOPE LN
SANDY UT
84092-2553
US

V. Phone/Fax

Practice location:
  • Phone: 801-571-0009
  • Fax:
Mailing address:
  • Phone: 801-699-6526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF11230477
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: