FLORENCE FAIRBANKS

TAYLORSVILLE, UT
NPI1154348993
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: UT  2103544405)
Enumeration Date2006-07-17
Last Update Date2007-07-08
Business Address
-- FLORENCE FAIRBANKS APRN
5770 S 1500 W
TAYLORSVILLE, UT 84123-5216
Phone number: 801-265-3144
Mailing Address
-- FLORENCE FAIRBANKS APRN
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: 801-265-3144
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