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Individual

AMANDA DUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
560 W 465 N # 601, PROVIDENCE, UT 84332-8006
(435) 554-8719
Mailing address
560 W 465 N # 601, PROVIDENCE, UT 84332-8006

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
11770648-3102
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11770648-4405
UT

Other

Enumeration date
05/09/2025
Last updated
10/04/2025
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