Healthcare Provider Details

I. General information

NPI: 1124470133
Provider Name (Legal Business Name): KATHERINE HELLER DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2016
Last Update Date: 03/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9720 S 1300 E SUITE W-120
SANDY UT
84094-3712
US

IV. Provider business mailing address

9720 S 1300 E SUITE W-120
SANDY UT
84094-3712
US

V. Phone/Fax

Practice location:
  • Phone: 801-572-6700
  • Fax: 801-571-0081
Mailing address:
  • Phone: 801-572-6700
  • Fax: 801-571-0081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7922919-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: