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General NPI Number Information
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NPI Number | 1366032351
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Entity Type | Organization
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Legal Business Name | VALLEY FAMILY MEDICAL
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Dates
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Enumeration Date | 01/22/2021
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 2595 N HIGHWAY 162
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City | EDEN
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State | UT
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Zip | 84310-6711
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Country | US
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Telephone | 801-668-2910
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Fax | 801-340-0306
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Provider Business Mailing Address
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Address Line | PO BOX 1045
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City | EDEN
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State | UT
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Zip | 84310-1045
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Country | US
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Telephone | 801-668-2910
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Fax | 801-340-0306
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Authorized Official
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Title or Position | OWNER
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Name | MRS. EMILY BALL
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Credential | FNP-C MPH
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Telephone | 970-379-8773
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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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