| NPI | 1093480584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA RAE OAKLEY Executive Director 801-368-4499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 2080H0002X |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2021-08-16 |