MIKKA MICHELE PENDERGRASS

SALT LAKE CITY, UT
NPI1649846304
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: UT  86680593102)
Enumeration Date2021-06-02
Last Update Date2021-11-11
Business Address
MIKKA MICHELE PENDERGRASS AGACNP
1950 CIRCLE OF HOPE DR
SALT LAKE CITY, UT 84112-5500
Phone number: 801-581-2436
Mailing Address
MIKKA MICHELE PENDERGRASS AGACNP
461 S 400 E
AMERICAN FORK, UT 84003-2515
Phone number: 801-901-7688
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