| NPI | 1487761615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENAISA NAY Geriatric Nurse Practitioner 801-391-4585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: UT 200842-4405) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-08-22 |