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Individual

MS. PAULA RUTH PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
100 NORTH MEDICAL DRIVE, SALT LAKE CITY, UT 84113
(801) 662-1678
(801) 662-1676
Mailing address
100 NORTH MEDICAL DRIVE, SALT LAKE CITY, UT 84113
(801) 662-1678
(801) 662-1676

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
181971-4405
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
942854058211
UT
Enumeration date
05/02/2007
Last updated
04/04/2023
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