Organization
WASATCH NURSE PRACTITIONER SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA W BAGLEY FNP (OWNER)
(801) 918-9793
Entity
Organization
Contact information
Practice address
3683 WILDROSE LN, SALT LAKE CITY, UT 84109-4324
(801) 918-9793
Mailing address
3683 WILDROSE LN, SALT LAKE CITY, UT 84109-4324
(801) 918-9793
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1166904405
UT
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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