Healthcare Provider Details

I. General information

NPI: 1649309964
Provider Name (Legal Business Name): LISA JONES CONLEY RN, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2007
Last Update Date: 12/26/2025
Certification Date: 12/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 N MEDICAL DR
SLC UT
84132-0001
US

IV. Provider business mailing address

1196 WILD TREE CIR
DRAPER UT
84020-7552
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-2746
  • Fax:
Mailing address:
  • Phone: 801-572-2901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number215643-4405
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number215643-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: