Individual
TREVOR GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-4300
(801) 387-4306
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
11588995-3102
UT
363LN0000X
Neonatal Nurse Practitioner
Primary
904352-4405
UT
Other
Enumeration date
12/18/2023
Last updated
03/15/2024
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