Wasatch Nurse Practitioner Services

NPI 1063798403 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1063798403
Enumeration Date 10/31/2011
Last Updated 10/31/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name SANDRA W SANDRA
Position OWNER
Phone (801) 918-9793
Fax
Practice Location
3683 WILDROSE LN
SALT LAKE CITY UT, 84109-4324, US
Phone (801) 918-9793
Fax
Business Location
3683 WILDROSE LN
SALT LAKE CITY UT, 84109-4324, US
Phone (801) 918-9793
Fax
Toxanomy
Taxonomy Code 363LF0000X
License State Utah
License Number 1166904405
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According to our database, Wasatch Nurse Practitioner Services NPI is 1063798403, taxonomy code is 363LF0000X and license number is 1166904405, license state is located at Utah. Wasatch Nurse Practitioner Services physically located at 3683 Wildrose Ln, Salt Lake City UT, 84109-4324. NPI Number 1033115704 has the healthcare provider type.

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1063798403 NPI number is provided on an as is basis without warranty of any kind. 1063798403 is maintained by the National Plan & Provider Enumeration System. The contents of Wasatch Nurse Practitioner Services are for informational purposes only.