Healthcare Provider Details

I. General information

NPI: 1538542840
Provider Name (Legal Business Name): TIFFANY ROSE PULGIANO DNP, A/GNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2015
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3570 W 9000 S STE 210
WEST JORDAN UT
84088-8876
US

IV. Provider business mailing address

3570 W 9000 S STE 210
WEST JORDAN UT
84088-8876
US

V. Phone/Fax

Practice location:
  • Phone: 801-457-1172
  • Fax: 801-516-0076
Mailing address:
  • Phone: 801-457-1172
  • Fax: 801-516-0076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number7994701-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: