Provider Demographics
NPI:1295842094
Name:EPHRONI, ANNETTE M (APRN)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:M
Last Name:EPHRONI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:MILLIRON
Other - Last Name:EPHRONI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:545 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-3810
Mailing Address - Country:US
Mailing Address - Phone:801-583-0404
Mailing Address - Fax:
Practice Address - Street 1:275 E SOUTH TEMPLE STE 250
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84111-1273
Practice Address - Country:US
Practice Address - Phone:801-971-7815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6009592-4408363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health