MEDICARE: HILARY THOMAS FNP

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	363L00000X	Nurse Practitioner	11565771-4405	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841888211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILARY THOMAS FNP

Provider Business Mailing Address
First Line	:	11693 S 700 E STE 200
Second Line	:
City	:	DRAPER
State	:	UT
Zip	:	84020-7573
Country	:	US
Telephone Number	:	801-810-2147
Fax Number	:

Provider Business Practice Location Address
First Line	:	8841 S REDWOOD RD STE D
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84088-9289
Country	:	US
Telephone Number	:	801-610-1868
Fax Number	:

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

Provider Enumeration Date	:	01/01/2021
Last Update Date	:	09/18/2022

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