Individual
EKAETE UDODONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1886 W 800 N, PLEASANT GROVE, UT 84062-4097
(801) 756-5288
(801) 756-7589
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
198596-4405
UT
363L00000X
Nurse Practitioner
Primary
198596-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D6316
—
UT
Enumeration date
04/06/2006
Last updated
11/27/2023
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