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Individual
MR. GLENDON ARLY PEDERSEN
Active
Individual
MR. GLENDON ARLY PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
247000000X
Health Information Technician
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
5581789-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5581789-4405
UTAH STATE LICENSE
UT
Enumeration date
05/02/2011
Last updated
06/08/2023
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