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General NPI Number Information
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NPI Number | 1598549339
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Entity Type | Individual
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Provider Name | ALEX TRUONG APRN
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Gender | Male
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Dates
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Enumeration Date | 08/22/2023
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 50 N MEDICAL DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84132-0001
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Country | US
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Telephone | 801-581-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 2573 W MIDAS SIDE WAY
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City | RIVERTON
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State | UT
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Zip | 84065-7919
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Country | US
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Telephone | 801-386-1845
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9824608-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 9824608-4405
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License Number State | UT
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