Individual
HANNAH ROSE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1132 E DRAPER PKWY, DRAPER, UT 84020-9095
(801) 878-7411
Mailing address
13787 S LINDA MARIE LN, RIVERTON, UT 84065-2316
(801) 244-8467
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
12649947-3102
UT
363L00000X
Nurse Practitioner
12649947-4405
UT
363LP2300X
Primary Care Nurse Practitioner
Primary
12649947-4405
UT
Other
Enumeration date
05/15/2025
Last updated
12/04/2025
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