Individual
SUSAN K CHURCHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
400 C ST, SALT LAKE CITY, UT 84143-1005
(801) 408-3623
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 408-3623
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2147004405
UT
Other
Enumeration date
07/20/2006
Last updated
03/18/2008
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