Individual
VICTORIA AU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7109
Mailing address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7109
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
10217010-3102
UT
363L00000X
Nurse Practitioner
10217010-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
10217010-4405
UT
Other
Enumeration date
06/02/2020
Last updated
05/31/2022
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