Individual
ELIZABETH J AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1055 N 500 W, STE 205, BUILDING C, PROVO, UT 84604-3305
(801) 429-8095
(801) 354-8265
Mailing address
1055 N 500 W, ATT: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8226
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14240564-1206
UT
Other
Enumeration date
03/01/2023
Last updated
09/17/2025
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