National Provider Identifier Database

MARK DUDLEY, APRN – NPI #1144223678
Psychiatric/Mental Health, Adult


Contact Information

MARK DUDLEY, APRN
1399 S 700 E STE 11B
SALT LAKE CITY, UT84105-2149
Phone: 801-918-9890
Fax: 801-466-3195
Website:
Specialty Taxonomy Code
* Psychiatric/Mental Health, Adult 364SP0809X

* Indicates primary specialty

NPI Profile & details for MARK DUDLEY

NPI Number 1144223678
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 05/30/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 Yes
Identifiers
  • UT License #: 1361364405
  • UT Other: 94293834884047A017 CHAMPUS
  • UT Other: 262137 DESERET MUTUAL
  • UT Other: 107002906101 INTERMOUNTAIN HEALTH CARE
  • UT Other: P33212 MEDICARE ADVANTAGE PLUS
Hospital affiliation n/a

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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