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General NPI Number Information
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NPI Number | 1548557622
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Entity Type | Individual
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Provider Name | HALEY B NELSON FNP, NP-C, APRN
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Gender | Female
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 10/09/2020
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Provider Practice Location Address
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Address Line | 7353 S 2172 W
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City | WEST JORDAN
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State | UT
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Zip | 84084-3248
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Country | US
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Telephone | 801-703-3257
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Fax |
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Provider Business Mailing Address
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Address Line | 7353 S 2172 W
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City | WEST JORDAN
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State | UT
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Zip | 84084-3248
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Country | US
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Telephone | 801-703-3257
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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 | 5896884-4405
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License Number State | UT
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