Healthcare Provider Details

I. General information

NPI: 1164980181
Provider Name (Legal Business Name): ADAM THOMAS CREER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2019
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 S MAIN ST STE 108
SOUTH SALT LAKE UT
84115-6000
US

IV. Provider business mailing address

2880 S MAIN ST STE 108
SOUTH SALT LAKE UT
84115-6000
US

V. Phone/Fax

Practice location:
  • Phone: 240-356-1000
  • Fax:
Mailing address:
  • Phone: 240-356-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7417569-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: