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Life Tree Pllc
Psychiatric/Mental Health Nurse Practitioner in Salem, Utah
NPI 1982135265

Life Tree Pllc is a Psychiatric/Mental Health Nurse Practitioner based in Salem, UT and is specialized in Psychiatric/Mental Health. Life Tree Pllc practices in Salem, UT. The NPI Number for Life Tree Pllc is 1982135265 and holds a License No. (Utah).

The current practice location address for Life Tree Pllc is 251 W State Road 198 Ste 3, Salem, UT and can be reached out via phone at 801-504-6665 and via fax at 801-504-9073.

Location: 251 W State Road 198 Ste 3, Salem, UT, 84653-5608
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1982135265
Provider Name
Life Tree Pllc
Credential
Provider Entity Type
Organization
Address
251 W State Road 198 Ste 3, Salem, UT, 84653-5608
Phone Number
801-504-6665
Fax Number
801-504-9073
Provider Enumeration Date
03/27/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2019033956 01 ANCC PMHNP BOARD CERTIFICATION
institution
Provider Business Practice Location Address Details
Address
251 W State Road 198 Ste 3
City
Salem
State
Utah
Zip
84653-5608
Phone Number
801-504-6665
Fax Number
801-504-9073
person
Provider Business Mailing Address Details
Address
251 W State Road 198 Ste 3
City
Salem
State
Utah
Zip
84653-5608
Phone Number
801-504-6665
Fax Number
801-504-9073
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
261QM1300X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
6227164-4405 (Utah)
Definition
Definition to come...
person
Provider's Taxonomy Details 6
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
363LG0600X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 7
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
()
Definition
Definition to come...
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