Individual
RANDI MOORE HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1220 E 3900 S STE 1F, SALT LAKE CITY, UT 84124-1327
(801) 262-5711
Mailing address
1220 E 3900 S STE 1F, SALT LAKE CITY, UT 84124-1327
(801) 262-5711
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5038133-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5038133-4405
UT
Other
Enumeration date
09/23/2014
Last updated
07/07/2023
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