| NPI | 1417653031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARANDA CARLILE Owner 435-565-1384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2023-02-21 |