Individual
KIERSTIN PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
15 S 1000 E STE 300, PAYSON, UT 84651-5592
(801) 354-8225
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
49296874405
UT
363LF0000X
Family Nurse Practitioner
49296878900
UT
Other
Enumeration date
10/12/2015
Last updated
11/27/2023
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