Healthcare Provider Details

I. General information

NPI: 1538867742
Provider Name (Legal Business Name): SUSAN CAROL BYERLY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E CROSSROADS BLVD STE 639
SARATOGA SPRINGS UT
84045-2966
US

IV. Provider business mailing address

212 E CROSSROADS BLVD STE 639
SARATOGA SPRINGS UT
84045-2966
US

V. Phone/Fax

Practice location:
  • Phone: 435-359-4380
  • Fax:
Mailing address:
  • Phone: 435-359-4380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4776685-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: