MEDICARE: MS. EMILY KRISTEN VAN OS PMHNP-BC, 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	6621217-4405	UT
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	6621217-4405	UT

General Provider Information

NPI Number	:	1437406329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMILY KRISTEN VAN OS PMHNP-BC, FNP-C

Provider Business Mailing Address
First Line	:	2225 E MURRAY HOLLADAY RD STE 108
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84117-5384
Country	:	US
Telephone Number	:	801-609-6823
Fax Number	:	801-951-7221

Provider Business Practice Location Address
First Line	:	2225 E MURRAY HOLLADAY RD STE 108
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84117-5384
Country	:	US
Telephone Number	:	801-609-6823
Fax Number	:	801-951-7221

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

Provider Enumeration Date	:	08/09/2012
Last Update Date	:	05/08/2025

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