Most Relevant Information
Provider Data
| NPI Number: | 1003635004 |
| Provider Name: | EMMA FONG APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 118761824405 |
Most Important Dates
| Enumeration Date: | 10/07/2024 |
| Last Updated: | 10/23/2024 |
Provider Practice Location
3802 S 700 E
SALT LAKE CITY
UT
841061182
Practice Location Phone/Fax
| Phone: | 8012646000 |
| Fax: |
Provider Mailing Location
971 W TIFFANY DALE WAY
BLUFFDALE
UT
840651836
Provider Mailing Phone/Fax
| Phone: | 8019600620 |
| Fax: |