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Individual

CAMMI JO FRUIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP-C

Contact information

Practice address
450 W 910 S STE 203, HEBER CITY, UT 84032-2447
(801) 712-0994
(888) 807-7464
Mailing address
1144 N 455 W UNIT 6, MIDWAY, UT 84049-6493
(801) 712-0994
(888) 807-7464

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
341638-4405
UT
363LG0600X
Gerontology Nurse Practitioner
341638-4405
UT

Other

Enumeration date
02/28/2021
Last updated
04/26/2022
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