Provider Demographics
NPI:1659903276
Name:THOMPSON, AMY SARAH (NP-DNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SARAH
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:NP-DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3876 W 2275 S
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:UT
Mailing Address - Zip Code:84401-7142
Mailing Address - Country:US
Mailing Address - Phone:801-389-9700
Mailing Address - Fax:
Practice Address - Street 1:2468 W 1675 S
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:UT
Practice Address - Zip Code:84401-6766
Practice Address - Country:US
Practice Address - Phone:801-389-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-11
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT343058-3102163WN0002X
UT343058-4405363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care