Healthcare Provider Details

I. General information

NPI: 1679390504
Provider Name (Legal Business Name): CURTIS LURA FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 E 400 N STE 110
VINEYARD UT
84059-7509
US

IV. Provider business mailing address

691 E 400 N STE 110
VINEYARD UT
84059-7509
US

V. Phone/Fax

Practice location:
  • Phone: 385-203-0246
  • Fax:
Mailing address:
  • Phone: 385-203-0246
  • Fax: 385-203-0245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12367665-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: