Organization
NORTHERN VALLEY FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LYNN TAGG FNP (OWNER)
(801) 557-5024
Entity
Organization
Contact information
Practice address
1415 N 400 E STE A, LOGAN, UT 84341-7539
(435) 753-2840
(435) 787-9422
Mailing address
415 W 3400 S, NIBLEY, UT 84321-6461
(801) 557-5024
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/20/2025
Last updated
02/20/2025
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