# INTERMOUNTAIN HEALTH CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558691873
- **Authorized official:** MRS. SUZANNE CARBAUGH APRN/NNP (ADVANCE PRACTICE REGISTERED NURSE,)
- **Authorized official phone:** (801) 662-4100

## Contact information

- **Practice address:** 100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
- **Practice address phone:** (801) 662-4100
- **Mailing address:** 100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
- **Mailing address phone:** (801) 662-4100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LN0000X | Neonatal Nurse Practitioner | 351798-4405 | UT | Yes |

## Other

- **Enumeration date:** 01/08/2010
- **Last updated:** 01/08/2010