Healthcare Provider Details

I. General information

NPI: 1982528642
Provider Name (Legal Business Name): KATELIN IONA JOHNSON MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

454 E 340 N
VINEYARD UT
84059-7504
US

IV. Provider business mailing address

454 E 340 N
VINEYARD UT
84059-7504
US

V. Phone/Fax

Practice location:
  • Phone: 801-376-2176
  • Fax:
Mailing address:
  • Phone: 801-376-2176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number12868296-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: