Healthcare Provider Details

I. General information

NPI: 1427080670
Provider Name (Legal Business Name): HEATHER CAMPBELL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3725 W 4100 SOUTH
WEST VALLEY CITY UT
84120
US

IV. Provider business mailing address

3725 W 4100 SOUTH
WEST VALLEY CITY UT
84120
US

V. Phone/Fax

Practice location:
  • Phone: 801-965-3600
  • Fax: 801-965-3526
Mailing address:
  • Phone: 801-965-3600
  • Fax: 801-965-3526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number199768-4405
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1997684405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: