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General NPI Number Information
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NPI Number | 1699463984
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Entity Type | Individual
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Provider Name | JOANNIE AMORES MARTIN
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Gender | Female
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Dates
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Enumeration Date | 04/26/2023
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Last Update Date | 12/08/2024
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Provider Practice Location Address
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Address Line | 1950 CIRCLE OF HOPE DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84112-5500
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Country | US
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Telephone | 801-587-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 1265 N 325 E
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City | BOUNTIFUL
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State | UT
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Zip | 84010-4539
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Country | US
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Telephone | 801-866-9131
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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 | 9079298-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9079298-4405
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 9079298-3102
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License Number State | UT
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