Provider Demographics
NPI:1891369732
Name:ALLEN, DESERET DAY (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:DESERET
Middle Name:DAY
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 E GORDON AVE STE 1&2
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-2341
Mailing Address - Country:US
Mailing Address - Phone:385-786-6100
Mailing Address - Fax:385-786-6102
Practice Address - Street 1:209 E GORDON AVE STE 1
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2357
Practice Address - Country:US
Practice Address - Phone:801-941-9280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-15
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT377163-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT377163-4405OtherUTAH DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING