Healthcare Provider Details

I. General information

NPI: 1184316143
Provider Name (Legal Business Name): DEANNA BETH ALLEN DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3212 W WINTER CREEK CIR
SOUTH JORDAN UT
84095-5967
US

IV. Provider business mailing address

3212 W WINTER CREEK CIR
SOUTH JORDAN UT
84095-5967
US

V. Phone/Fax

Practice location:
  • Phone: 130-388-3732
  • Fax:
Mailing address:
  • Phone: 130-388-3732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number4872351-4402
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number4872351-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: