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1740305150
STACEY BUSHELL
LAYTON, UT
NPI
1740305150
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: UT 195616-4405)
Enumeration Date
2007-03-21
Last Update Date
2007-07-08
Business Address
-- STACEY BUSHELL APRN
1580 W ANTELOPE DR SUITE 100
LAYTON, UT 84041-1160
Phone number: 801-773-8644
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Mailing Address
-- STACEY BUSHELL APRN
1580 W ANTELOPE DR SUITE 100
LAYTON, UT 84041-1160
Phone number: 801-773-8644
Copy
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