MEDICARE: MRS. ERIN HANSON DOPPELHEUER FNP-C

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	F09220435	UT

General Provider Information

NPI Number	:	1134805997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIN HANSON DOPPELHEUER FNP-C

Provider Business Mailing Address
First Line	:	660 E WILMINGTON AVE UNIT B314
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-6423
Country	:	US
Telephone Number	:	703-966-4255
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 HOLLYHOCK ST
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84098-5577
Country	:	US
Telephone Number	:	703-966-4255
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2023
Last Update Date	:	06/26/2023

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