Individual
MRS. MINERVA ABELEDA DANTIS-TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
650 E 4500 S, STE 210, SALT LAKE CITY, UT 84107-4520
(801) 288-2634
(801) 288-1186
Mailing address
650 E 4500 S, STE 210, SALT LAKE CITY, UT 84107-4520
(801) 288-2634
(801) 288-1186
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5291704-4405
UT
363LF0000X
Family Nurse Practitioner
5291704-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164715124
—
UT
Enumeration date
05/24/2011
Last updated
03/25/2021
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