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1972069532
NATASHA NICOLLE PETERSON
PARK CITY, UT
NPI
1972069532
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: UT 8454365-4405)
Enumeration Date
2019-02-19
Last Update Date
2021-12-20
Business Address
NATASHA NICOLLE PETERSON
STAT MD, 1784 UINTA WAY E
PARK CITY, UT 84098
Phone number: 435-604-0160
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Mailing Address
NATASHA NICOLLE PETERSON
3741 S CANLEY VALE CT
SALT LAKE CITY, UT 84115-3131
Phone number: 801-699-6656
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