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Contact Information

RYAN D CHURCH, FNP-C
1220 E 3900 S STE 1F
SALT LAKE CITY, UT84124-1327
 Phone: 801-262-5711
 Fax: 801-262-5741
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for RYAN D CHURCH · (Male)

NPI # 1912909714
Status Active
Credentials FNP-C (Family Nurse Practitioner, Certified)
Entity Individual
Enumeration date 08/11/2005
Last updated 11/11/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 278935-4405
  • UT Other 27893544001001 BCBS
  • UT Other P99858 UPIN
Hospital affiliation(s)
  • JORDAN VALLEY MEDICAL CENTER - (Acute Care)
    3580 WEST 9000 SOUTH
    WEST JORDAN, UT 84088
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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