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NPI Code Detail

MEDICARE: TARA HULL FNP-C

MEDICARE:   TARA  HULL  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
1363L00000XNurse Practitioner10681833-4405UT

General Provider Information

NPI Number : 1306646211
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA HULL FNP-C
Provider Business Mailing Address
First Line : 2830 S BEVERLY ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84106-3170
Country : US
Telephone Number : 912-506-8486
Fax Number :
Provider Business Practice Location Address
First Line : 2830 S BEVERLY ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84106-3170
Country : US
Telephone Number : 912-506-8486
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2025
Last Update Date : 03/18/2025

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