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Organization
INTERMOUNTAIN HEALTHCARE
Active
Organization
INTERMOUNTAIN HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISA ANN EDWARDS APRN (FAMILY NURSE PRACTITIONER)
(435) 313-6330
Entity
Organization
Contact information
Practice address
884 BLACK ROCK DR, SANTA CLARA, UT 84765-5440
(435) 313-6330
Mailing address
884 BLACK ROCK DR, SANTA CLARA, UT 84765-5440
(435) 313-6330
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
6078476-4405
UT
Other
Enumeration date
01/27/2016
Last updated
01/27/2016
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