Healthcare Provider Details

I. General information

NPI: 1801540497
Provider Name (Legal Business Name): HEATHER WARNER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2022
Last Update Date: 02/11/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 W 6400 S
SPANISH FORK UT
84660-5005
US

IV. Provider business mailing address

1733 W 6400 S
SPANISH FORK UT
84660-5005
US

V. Phone/Fax

Practice location:
  • Phone: 801-368-4327
  • Fax:
Mailing address:
  • Phone: 801-368-4327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number7333716-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: