Individual
AUSTIN KING FACKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
5132 HEIDI WAY, ERDA, UT 84074-9246
(435) 773-8173
Mailing address
5132 HEIDI WAY, ERDA, UT 84074-9246
(435) 773-8173
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11081203-4405
UT
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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