| NPI | 1003521485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJ YERGENSEN Admin 435-986-9369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health |
| Enumeration Date | 2023-01-19 |
| Last Update Date | 2023-01-19 |