Doctor Name: | HEATHER MISSY BERKEL |
NPI Number: | 1326372764 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 3083662-4405 |
Business Practice Address: | 2850 N 2000 W Ste 101 Farr West, UT - 844049230 |
Business Phone Number: | 8017320805 |
Business Fax Number: | 3853334233 |
Mailing Address: | 2850 N 2000 W Ste 101, FARR WEST |
State: | UT |
Postal Code: | 844049230 |
Phone Number: | 8017320805 |
Fax Number: | 3853334233 |
NPI Enumeration Date: | 10/01/2009 |
NPI Last Update Date: | 12/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3083662-4405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |