Individual
LIANA TETEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, PC, MHP
Contact information
Practice address
120 PARKVIEW TER, PARK CITY, UT 84098-5106
(435) 714-0000
Mailing address
120 PARKVIEW TER, PARK CITY, UT 84098-5106
(435) 714-0000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
267089
CA
Other
Enumeration date
01/18/2014
Last updated
01/18/2014
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