Provider Demographics
NPI:1497850069
Name:ORMOND, DALLEN K (FNP)
Entity Type:Individual
Prefix:MR
First Name:DALLEN
Middle Name:K
Last Name:ORMOND
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11237 AUTUMN VIEW CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-8404
Mailing Address - Country:US
Mailing Address - Phone:801-282-2175
Mailing Address - Fax:
Practice Address - Street 1:1268 W SOUTH JORDAN PKWY STE 201
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-4653
Practice Address - Country:US
Practice Address - Phone:801-254-9700
Practice Address - Fax:801-254-9755
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT344095-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily