Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mikka Michele Pendergrass, AGACNP

Individual provider Acute Care Nurse Practitioner · NPI 1649846304

Mikka Michele Pendergrass, AGACNP is a Nurse Practitioner in Salt Lake City, Utah. Qualified in 2021, 5 years ago. Practices with University of Utah Adult Services, a 1,740-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
5
Licensed in
UT
In the registry since
2021
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Practice location Address checks out

1950 Circle Of Hope Dr
Salt Lake City, UT 84112-5500
Phone: (801) 581-2436
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 86680593102 (UT)

Record details

NPI number1649846304
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedJune 2, 2021
Last updated in NPPESNovember 11, 2021
Certification dateNovember 11, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice University Of Utah Adult Services — 1740 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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