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General NPI Number Information
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NPI Number | 1508383175
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Entity Type | Individual
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Provider Name | CYNTHIA ANN WHITING NP
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Gender | Female
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 08/24/2017
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Provider Practice Location Address
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Address Line | 10433 S REDWOOD RD STE B
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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 | 801-501-0500
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Fax | 801-253-0626
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Provider Business Mailing Address
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Address Line | PO BOX 95590
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-0590
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Country | US
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Telephone | 801-352-9500
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Fax | 801-352-7976
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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 | 5807285-4405
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License Number State | UT
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