| NPI | 1033674916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEE STEVENS Owner/Operator 435-764-1775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2020-06-18 |