Michael R Humphrey, WHNP-BC, FNP-C

Individual provider Active NPI Women's Health Nurse Practitioner · Hill Afb, UT

NPI 1306394697 · NPPES record last updated Jan 24, 2025

Key facts

NPI
1306394697
Entity type
Individual (NPI type 1)
Primary specialty
Women's Health Nurse Practitioner 363LW0102X
License
13065075-4405 (UT)
Practice address
7321 Balmer St
Hill Afb, UT 84056-5012
Phone
(801) 777-7028
NPI assigned
Sep 14, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
13065075-4405UTMDWomen's Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LW0102X 13065075-4405 UT Yes

Addresses

Primary practice location

7321 Balmer St
Hill Afb, UT 84056-5012

Mailing address

7321 Balmer St
Hill Afb, UT 84056-5012
Phone (801) 777-7028

Other providers in Hill Afb, UT

All providers in Hill Afb, UT · Women's Health Nurse Practitioner in Utah

Sources for this page

Verify at the official NPI Registry.