Provider Demographics
NPI:1316192321
Name:WARD, DENISE EVANS (FNP)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:EVANS
Last Name:WARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:801-209-3601
Mailing Address - Fax:
Practice Address - Street 1:324 E 10TH AVE STE 170
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103-2858
Practice Address - Country:US
Practice Address - Phone:801-322-1000
Practice Address - Fax:801-442-0643
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT178569-8900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily