Individual
REBECCA EMILY ENNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
750 ROUND VALLEY DR STE 201, PARK CITY, UT 84060-7549
(435) 649-7680
(435) 776-9353
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(435) 649-7680
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11273913-4405
UT
363LF0000X
Family Nurse Practitioner
NP17730
CA
Other
Enumeration date
01/28/2008
Last updated
10/11/2023
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