NPI 1013212802

Your Home Clinic Company

Organisation Gerontology Nurse Practitioner Salt Lake City, UT

Practice location

Address: 1032 Learned Ave, Salt Lake City, UT 84116-3302
Phone: (801) 641-9261
Fax: (801) 521-4496

Authorised official

Name: Cynthia Ann Newby
Title: President
Phone: (801) 641-9261

Registered specialties

Gerontology Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LG0600X Licence 308579-4405 (UT)

Other Nurse Practitioner providers in Utah →

Registry record

NPI: 1013212802
Entity type: Organization
NPI issued: 25 Jan 2011
Record last updated: 25 Jan 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.