Individual
THERESA WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
63 E 800 N, SPANISH FORK, UT 84660-1210
(801) 798-8750
Mailing address
PO BOX 784, MONA, UT 84645-1001
(956) 457-9658
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11088822-4405
UT
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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