Healthcare Provider Details

I. General information

NPI: 1831051077
Provider Name (Legal Business Name): AMY GOLDEN GREENHALGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2758 E AUBURN DR
ST GEORGE UT
84790-4216
US

IV. Provider business mailing address

2758 E AUBURN DR
ST GEORGE UT
84790-4216
US

V. Phone/Fax

Practice location:
  • Phone: 801-360-7774
  • Fax:
Mailing address:
  • Phone: 801-360-7774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number4771315-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: