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Organization
EASTERN UTAH WOMENS HEALTH LLC
Active
Organization
EASTERN UTAH WOMENS HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE PENDERGRASS DNP, APRN, WHNP-BC (PRESIDENT)
(435) 637-0313
Entity
Organization
Contact information
Practice address
77 S 600 E STE B, PRICE, UT 84501-3174
(435) 637-0313
(435) 637-0317
Mailing address
PO BOX 656, PRICE, UT 84501-0656
(435) 637-0313
(435) 637-0317
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
3196374405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225257819
—
UT
Enumeration date
04/19/2018
Last updated
04/19/2018
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