Sandra W Bagley, APRN PHD MSW
Individual provider Active NPI Family Nurse Practitioner · Salt Lake City, UT
NPI 1023022415 · NPPES record last updated Aug 9, 2026
Key facts
- NPI
- 1023022415
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1166904405 (UT)
- Practice address
- 3683 Wilde Rose Lane
Salt Lake City, UT 84109 - Phone
- (801) 273-0295
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1166903502 | UT | MD | Social Worker |
| 1166903902 | UT | MD | Marriage & Family Therapist |
| 1166904405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nate Ruden MD LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 1166903502 | UT | |
| Family Nurse Practitioner | 363LF0000X | 1166904405 | UT | Yes |
| Marriage & Family Therapist | 106H00000X | 1166903902 | UT |
Addresses
Primary practice location
3683 Wilde Rose Lane
Salt Lake City, UT 84109
Mailing address
3683 Wilde Rose Lane
Salt Lake City, UT 84109
Phone (801) 273-0295
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| U000075209 | Other | UT | PTAN |
Other providers in Salt Lake City, UT
- Ana Bagley
- Joel Kevin Bagley II
- Kimra Bagley
- Lisa Dunn Bagley
- Robert Bagley
- Tricia Bagley
- Jordan Lee Bagnall
- Roxana Bahani
- Stephanie Bahena Alvarez
- Leticia Bahena
All providers in Salt Lake City, UT · Family Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.