Individual
SAMUEL R EVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
154 E MYRTLE AVE STE 204, MURRAY, UT 84107-4850
(801) 369-8989
(801) 704-9741
Mailing address
154 E MYRTLE AVE STE 204, MURRAY, UT 84107-4850
(801) 369-8989
(801) 704-9741
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
9492493-1206
UT
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
9492493-1206
UT
Other
Enumeration date
12/11/2014
Last updated
10/12/2023
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