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General NPI Number Information
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NPI Number | 1447070156
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Entity Type | Individual
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Provider Name | DANE WOODWARD FNP
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Gender | Male
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1868 N 1200 W
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City | LAYTON
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State | UT
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Zip | 84041-1939
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Country | US
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Telephone | 801-614-2772
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Fax |
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Provider Business Mailing Address
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Address Line | 10433 S REDWOOD RD # 2
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-8502
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Country | US
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Telephone | 801-260-1919
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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 | 10846405-4405
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License Number State | UT
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