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Nurse Practitioner

NPI: 1407430366Individual

Specialties, Licenses & Credentials

Nurse PractitionerPrimary

Nurse Practitioner

Code: 363L00000X

10200904-3102(UT)

Contact & Hours

Address: 8TH AVE AND C ST
SALT LAKE CITY, UT 84143
Phone: (801) 408-3340

Quick Facts

NPI: 1407430366
Entity Type: Individual
Gender: Male
Medicare: Not confirmed
Specialties: 1
Locations: 1

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