Individual
MRS. TRACI LYNN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3225 W GORDON AVE, #1, LAYTON, UT 84041-6508
(801) 773-7232
(801) 927-4218
Mailing address
3225 W GORDON AVE, #1, LAYTON, UT 84041-6508
(801) 773-7232
(801) 927-4212
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5696047-4405
UT
Other
Enumeration date
01/15/2010
Last updated
07/07/2011
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