NPI 1073125373

Brenda Lee Waller

Practitioner Pharmacy Technician Salt Lake City, UT

Practice location

Address: 729 N Redwood Rd, Salt Lake City, UT 84116-1909
Phone: (801) 532-3795
Fax: (801) 532-4909
Mailing address: PO Box 16495, Salt Lake City, UT 84116

Registered specialties

Pharmacy Technician Primary

Pharmacy Service Providers Taxonomy 183700000X Licence 9250968-1717 (UT)

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Registry record

NPI: 1073125373
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Aug 2020
Record last updated: 18 Aug 2020

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.