Healthcare Provider Details

I. General information

NPI: 1336070374
Provider Name (Legal Business Name): CODY MORGAN MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3865 S 5000 W
WEST HAVEN UT
84401-5622
US

IV. Provider business mailing address

29 W COTTAGE AVE
SANDY UT
84070-1474
US

V. Phone/Fax

Practice location:
  • Phone: 801-390-5003
  • Fax: 801-618-3586
Mailing address:
  • Phone: 801-518-2646
  • Fax: 385-324-6610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CODY MORGAN
Title or Position: OWNER
Credential: FNP-BC
Phone: 801-390-0503