Provider Demographics
NPI:1902178650
Name:ALDRIDGE, MARK AARON (FNP)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:AARON
Last Name:ALDRIDGE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 W 9000 S
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-2551
Mailing Address - Country:US
Mailing Address - Phone:801-562-5200
Mailing Address - Fax:
Practice Address - Street 1:385 W 9000 S
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-2551
Practice Address - Country:US
Practice Address - Phone:801-562-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-27
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9124468-4405261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care