Individual
DR. BRIANNA LASTRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, WHNP, CNM
Contact information
Practice address
1446 W PLEASANT GROVE BLVD., PLEASANT GROVE, UT 84062
(801) 785-5100
Mailing address
1446 W PLEASANT GROVE BLVD., PLEASANT GROVE, UT 84062
(801) 785-5100
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
7247318-4405
UT
Other
Enumeration date
08/01/2013
Last updated
08/01/2013
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