Healthcare Provider Details

I. General information

NPI: 1851247241
Provider Name (Legal Business Name): MELISSA THOMAS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2026
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

764 SUNSET DR
SANTAQUIN UT
84655-5658
US

IV. Provider business mailing address

764 SUNSET DR
SANTAQUIN UT
84655-5658
US

V. Phone/Fax

Practice location:
  • Phone: 801-995-3178
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number316946-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: