Healthcare Provider Details

I. General information

NPI: 1669213278
Provider Name (Legal Business Name): CONNER ASHTON FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2024
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2376 N 400 E STE 202
TOOELE UT
84074-3413
US

IV. Provider business mailing address

1620 N MAIN ST
SPANISH FORK UT
84660-1008
US

V. Phone/Fax

Practice location:
  • Phone: 435-833-9600
  • Fax:
Mailing address:
  • Phone: 844-354-9144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12038347-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: