MEDICARE: DR. MICHELLE EVA MORHOLT DNP, ARNP, 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	AP61020139	WA

General Provider Information

NPI Number	:	1508403197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE EVA MORHOLT DNP, ARNP, FNP-C

Provider Business Mailing Address
First Line	:	53 E REDONDO AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84115-2304
Country	:	US
Telephone Number	:	801-599-3964
Fax Number	:

Provider Business Practice Location Address
First Line	:	53 E REDONDO AVE
Second Line	:
City	:	SALT LAKE CTY
State	:	UT
Zip	:	84115-2304
Country	:	US
Telephone Number	:	206-596-3101
Fax Number	:	833-929-2536

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

Provider Enumeration Date	:	12/03/2019
Last Update Date	:	03/25/2021

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