SUSAN V. BASTA

SALT LAKE CITY, UT
NPI1952491581
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: UT  212263-4405)
Enumeration Date2006-10-13
Last Update Date2021-10-21
Business Address
SUSAN V. BASTA APRN
546 E CHIPETA WAY STE 220
SALT LAKE CITY, UT 84108-1221
Phone number: 801-581-7172
Mailing Address
SUSAN V. BASTA APRN
PO BOX 413034
SALT LAKE CITY, UT 84141-3034
Phone number: 801-213-3900
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