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General NPI Number Information
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NPI Number | 1982284873
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Entity Type | Individual
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Provider Name | EMILY ANNE LEWIS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 11/23/2022
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Provider Practice Location Address
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Address Line | 2965 W 3500 S
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City | WEST VALLEY CITY
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State | UT
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Zip | 84119-3602
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Country | US
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Telephone | 801-965-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 1496 E SPRING GATE DR
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City | HOLLADAY
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State | UT
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Zip | 84117-6893
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Country | US
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Telephone |
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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 | 9043726-4405
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License Number State | UT
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