Individual
NEIL PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 SPENCER W KIMBALL TOWER BLDG KMBL, PROVO, UT 84602-4704
(801) 422-4893
(801) 422-4893
Mailing address
500 SPENCER W KIMBALL TOWER BLDG KMBL, PROVO, UT 84602-4704
(801) 422-4893
(801) 422-4893
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024169615
VA
363L00000X
Nurse Practitioner
Primary
9115286-4405
UT
Other
Enumeration date
10/16/2012
Last updated
10/30/2025
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