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Individual

SONDRA DIANE HEASTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
3215 VALLEY ST, SALT LAKE CITY, UT 84109-4217
(801) 466-3102
Mailing address
1481 N 1450 E, PROVO, UT 84604-3714
(801) 377-1298

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
217181-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
217181-8900
UT

Other

Enumeration date
10/13/2006
Last updated
07/08/2007
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