Healthcare Provider Details

I. General information

NPI: 1801703038
Provider Name (Legal Business Name): MAAWA ALHAFID
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

30 S TOOELE BLVD
TOOELE UT
84074-2093
US

IV. Provider business mailing address

211 W 1160 N UNIT 6
TOOELE UT
84074-4622
US

V. Phone/Fax

Practice location:
  • Phone: 435-527-5256
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12175446-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: