Healthcare Provider Details

I. General information

NPI: 1902728710
Provider Name (Legal Business Name): CONNOR YATES RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3580 W 9000 S
WEST JORDAN UT
84088-8812
US

IV. Provider business mailing address

5082 W WOOD RANCH DR
SOUTH JORDAN UT
84009-1534
US

V. Phone/Fax

Practice location:
  • Phone: 801-561-8888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number12954509-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: