Provider Demographics
NPI:1629855051
Name:FELICITY WOMENS CENTER
Entity Type:Organization
Organization Name:FELICITY WOMENS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC-MENTAL HEALTH NURSE PRA
Authorized Official - Prefix:
Authorized Official - First Name:ALLYCE
Authorized Official - Middle Name:KATIE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:801-893-9564
Mailing Address - Street 1:12587 S FORT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9404
Mailing Address - Country:US
Mailing Address - Phone:801-893-9564
Mailing Address - Fax:801-893-9062
Practice Address - Street 1:12587 S FORT ST STE 202
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9404
Practice Address - Country:US
Practice Address - Phone:801-893-9564
Practice Address - Fax:801-893-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty