Provider Demographics
NPI:1639061161
Name:TUKUAFU, LYNETTE (NP)
Entity type:Individual
Prefix:
First Name:LYNETTE
Middle Name:
Last Name:TUKUAFU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1289 E ANDOVER CT
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-5669
Mailing Address - Country:US
Mailing Address - Phone:385-285-0686
Mailing Address - Fax:
Practice Address - Street 1:3725 W 4100 S STE 107
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-6063
Practice Address - Country:US
Practice Address - Phone:385-402-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT379089-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily