Provider Demographics
NPI:1508403197
Name:MORHOLT, MICHELLE EVA (DNP, ARNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:EVA
Last Name:MORHOLT
Suffix:
Gender:F
Credentials:DNP, ARNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 E REDONDO AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-2304
Mailing Address - Country:US
Mailing Address - Phone:801-599-3964
Mailing Address - Fax:
Practice Address - Street 1:53 E REDONDO AVE
Practice Address - Street 2:
Practice Address - City:SALT LAKE CTY
Practice Address - State:UT
Practice Address - Zip Code:84115-2304
Practice Address - Country:US
Practice Address - Phone:206-596-3101
Practice Address - Fax:833-929-2536
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61020139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily