MEDICARE: DUKE FAMILY & WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1104390111
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUKE FAMILY & WELLNESS

Provider Business Mailing Address
First Line	:	2909 WASHINGTON BLVD STE 248
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84401-3744
Country	:	US
Telephone Number	:	801-603-3246
Fax Number	:	801-797-0235

Provider Business Practice Location Address
First Line	:	2909 WASHINGTON BLVD STE 248
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84401-3744
Country	:	US
Telephone Number	:	801-603-3246
Fax Number	:	801-797-0235

Authorized Official
Title or Position	:	NURSE PRACTIONER
Name	:	CYNTHIA LYNN HAZELWOOD
Credential	:	FNP
Telephone Number	:	801-695-7587

Provider Enumeration Date	:	01/14/2019
Last Update Date	:	02/20/2025

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Directions to “DUKE FAMILY & WELLNESS ” Practice Location

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