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1376033456
DEVEN WILLARDSON
LOGAN, UT
NPI
1376033456
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: UT 8510230-4405)
Enumeration Date
2018-05-15
Last Update Date
2019-03-26
Business Address
DEVEN WILLARDSON BSN, RN
1350 N 500 E
LOGAN, UT 84341-2400
Phone number: 435-716-2800
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Mailing Address
DEVEN WILLARDSON BSN, RN
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number:
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