MEDICARE: ADAM THOMAS CREER

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	7417569-4405	UT

General Provider Information

NPI Number	:	1164980181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM THOMAS CREER

Provider Business Mailing Address
First Line	:	2880 S MAIN ST STE 108
Second Line	:
City	:	SOUTH SALT LAKE
State	:	UT
Zip	:	84115-6000
Country	:	US
Telephone Number	:	240-356-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2880 S MAIN ST STE 108
Second Line	:
City	:	SOUTH SALT LAKE
State	:	UT
Zip	:	84115-6000
Country	:	US
Telephone Number	:	240-356-1000
Fax Number	:

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

Provider Enumeration Date	:	03/08/2019
Last Update Date	:	12/10/2025

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Directions to “ ADAM THOMAS CREER ” Practice Location

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