=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508782152
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EUDEMONIA SPACE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2026
-----------------------------------------------------
Last Update Date | 06/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1033 E 2100 S # 201
-----------------------------------------------------
City | SALT LAKE CITY
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84106-4862
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-888-5378
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1370 E ROOSEVELT AVE
-----------------------------------------------------
City | SALT LAKE CITY
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84105-2614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-888-5378
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ELIZABETH S HANNA
-----------------------------------------------------
Credential | APRN
-----------------------------------------------------
Telephone | 801-888-5378
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2083P0901X
-----------------------------------------------------
Taxonomy Name | Public Health & General Preventive Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------