Provider Demographics
NPI:1700512076
Name:ENGLAND, MENDI (NP)
Entity Type:Individual
Prefix:
First Name:MENDI
Middle Name:
Last Name:ENGLAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7611 S JORDAN LANDING BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-5625
Mailing Address - Country:US
Mailing Address - Phone:801-486-1616
Mailing Address - Fax:
Practice Address - Street 1:5314 RIVER RUN DR STE 350
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-7708
Practice Address - Country:US
Practice Address - Phone:801-787-9855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTF07221692363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily