Individual
MS. KATHY JANE PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MPAS
Contact information
Practice address
4745 S 3200 W, SALT LAKE CITY, UT 84118-2822
(801) 964-6214
Mailing address
4745 S 3200 W, SALT LAKE CITY, UT 84118-2822
(801) 964-6214
(801) 412-6950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
102701-1206
UT
Other
Enumeration date
12/22/2005
Last updated
07/19/2007
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