Healthcare Provider Details

I. General information

NPI: 1891551370
Provider Name (Legal Business Name): PATRICIA ANNE MAJOR WILLARDSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10437 S JORDAN GTWY
SOUTH JORDAN UT
84095-3915
US

IV. Provider business mailing address

1221 S VALLEY GROVE WAY STE 1601221S
PLEASANT GROVE UT
84062-6753
US

V. Phone/Fax

Practice location:
  • Phone: 801-503-9211
  • Fax:
Mailing address:
  • Phone: 801-477-7189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number7396608-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: