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General NPI Number Information
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NPI Number | 1720940547
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Entity Type | Organization
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Legal Business Name | SUNRISE PSYCHIATRY AND WELLNESS PLLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1272 WEST 12700 SOUTH SUITE C
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City | RIVERTON
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State | UT
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Zip | 84065
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Country | US
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Telephone | 385-458-8572
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Fax | 888-496-9135
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Provider Business Mailing Address
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Address Line | 5526 W 13400 S # 345
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City | HERRIMAN
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State | UT
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Zip | 84096-6919
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Country | US
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Telephone | 385-458-8572
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Fax | 888-496-9135
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Authorized Official
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Title or Position | OWNER
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Name | AMBER HAWK
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Credential | APRN
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Telephone | 385-458-8572
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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