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General NPI Number Information
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NPI Number | 1952276651
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Entity Type | Individual
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Provider Name | SAMUEL TAGGER NOVEY FNP-C
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Gender | Male
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 5121 S COTTONWOOD ST
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City | MURRAY
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State | UT
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Zip | 84107-5701
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Country | US
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Telephone | 801-507-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 4771 S ANNABOW CIR
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City | HOLLADAY
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State | UT
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Zip | 84117-5408
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Country | US
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Telephone | 510-304-2906
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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 | 9131137-4405
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License Number State | UT
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