Individual
EMMA CAROL CALVERT ELISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
395 W COUGAR BLVD, PROVO, UT 84604-3311
(801) 357-7546
Mailing address
395 W COUGAR BLVD STE 401, PROVO, UT 84604-3338
(801) 357-7546
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
11128366-3102
UT
Other
Enumeration date
04/28/2020
Last updated
04/28/2020
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