Individual provider · NPI-1

Amanda Sue Al-Khudairi, MSN, RNC, APRN

Nurse Practitioner, Women's Health · Salt Lake City, UT

NPI number1861613242
StatusActive
Last updated in NPPESOct 16, 2021

Details

NPI
1861613242
Entity type
Individual (NPI-1)
Name
Mrs. Amanda Sue Al-Khudairi
Credential
MSN, RNC, APRN
Sex
Female
Sole proprietor
No
Enumeration date
May 1, 2007
Certification date
Oct 16, 2021
Last updated
Oct 16, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LW0102X Nurse Practitioner, Women's Health372242-4405UTYes

Practice location

1906 W 3600 S
Salt Lake City, UT 84119-4715

Phone 801-973-9675

Mailing address

6900 S 800 E
Midvale, UT 84047-1431

Phone 801-569-9363

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Nurse Practitioner, Women's Health providers in Salt Lake City, UT