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General NPI Number Information
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NPI Number | 1295519817
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Entity Type | Individual
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Provider Name | TONI PEMBERTON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/23/2023
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 230 N 1680 E STE N
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City | ST GEORGE
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State | UT
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Zip | 84790-2579
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Country | US
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Telephone | 435-246-7409
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Fax | 435-355-3898
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Provider Business Mailing Address
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Address Line | 621 S COYOTE RD
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City | APPLE VALLEY
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State | UT
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Zip | 84737-4921
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Country | US
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Telephone | 435-669-5952
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 365511-8900
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License Number State | UT
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