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General NPI Number Information
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NPI Number | 1104390111
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Entity Type | Organization
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Legal Business Name | DUKE FAMILY & WELLNESS
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 2909 WASHINGTON BLVD STE 248
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City | OGDEN
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State | UT
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Zip | 84401-3744
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Country | US
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Telephone | 801-603-3246
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Fax | 801-797-0235
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Provider Business Mailing Address
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Address Line | 2909 WASHINGTON BLVD STE 248
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City | OGDEN
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State | UT
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Zip | 84401-3744
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Country | US
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Telephone | 801-603-3246
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Fax | 801-797-0235
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Authorized Official
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Title or Position | NURSE PRACTIONER
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Name | CYNTHIA LYNN HAZELWOOD
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Credential | FNP
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Telephone | 801-695-7587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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