Provider Demographics
NPI:1811554751
Name:MOYERS, LANDON ROBERT (APRN, DNP, PMHNP)
Entity type:Individual
Prefix:
First Name:LANDON
Middle Name:ROBERT
Last Name:MOYERS
Suffix:
Gender:M
Credentials:APRN, DNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 E VINE ST STE 14
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-5541
Mailing Address - Country:US
Mailing Address - Phone:801-436-6556
Mailing Address - Fax:
Practice Address - Street 1:1771 E 11400 S
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84092-5426
Practice Address - Country:US
Practice Address - Phone:801-436-6556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-27
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8337120-4408363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health