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General NPI Number Information
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NPI Number | 1619846524
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Entity Type | Individual
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Provider Name | ANNETTA SINE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1845 W 4400 S STE A1
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City | ROY
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State | UT
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Zip | 84067-3049
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Country | US
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Telephone | 385-837-7010
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Fax | 855-434-8880
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Provider Business Mailing Address
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Address Line | 2324 W PENDLETON WAY
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-3473
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Country | US
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Telephone | 385-837-7010
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Fax | 855-434-8880
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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 | 7865751-4405
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License Number State | UT
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