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General NPI Number Information
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NPI Number | 1699485235
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Entity Type | Individual
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Provider Name | HALEY MARLENE MCINTOSH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 7430 S CREEK RD STE 104
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City | SANDY
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State | UT
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Zip | 84093-6160
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Country | US
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Telephone | 801-717-5644
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Fax | 801-797-0176
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Provider Business Mailing Address
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Address Line | 251 W 1525 N
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City | LAYTON
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State | UT
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Zip | 84041-5058
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Country | US
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Telephone | 801-698-4662
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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 | 10806101-4405
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License Number State | UT
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