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General NPI Number Information
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NPI Number | 1063251460
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Entity Type | Individual
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Provider Name | HEIDI AASE WINEGAR MSN, APRN, AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/23/2024
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 1250 E 3900 S STE 440
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City | SLC
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State | UT
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Zip | 84124-1349
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Country | US
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Telephone | 801-869-4100
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Fax | 801-869-4119
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Provider Business Mailing Address
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Address Line | 4331 W 9580 S
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City | SOUTH JORDAN
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State | UT
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Zip | 84009-9646
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Country | US
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Telephone | 801-856-4982
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 6158919-4405
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License Number State | UT
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