Individual
JUDY DE LA VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
972 N 600 E, SPANISH FORK, UT 84660-1306
(801) 465-4896
(385) 203-0392
Mailing address
1055 N 500 W, ATT CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
947995
TX
363LF0000X
Family Nurse Practitioner
Primary
13470553-4405
UT
Other
Enumeration date
02/27/2023
Last updated
03/04/2024
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