Provider Demographics
NPI:1235861493
Name:GONZALEZ, DARLENE J (MSN FNP-BC)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:J
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MSN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 N 470 W
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2267
Mailing Address - Country:US
Mailing Address - Phone:801-756-1404
Mailing Address - Fax:801-642-4926
Practice Address - Street 1:27 N 470 W
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2267
Practice Address - Country:US
Practice Address - Phone:801-756-1404
Practice Address - Fax:801-642-4926
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12667561-4405363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health