Individual
PHYLLIS A ASELTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3702 S STATE ST STE 107, SOUTH SALT LAKE, UT 84115-5096
(801) 288-2634
(801) 288-1186
Mailing address
3702 S STATE ST STE 107, SOUTH SALT LAKE, UT 84115-5096
(801) 288-2634
(801) 288-1186
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1835254405
UT
363LP2300X
Primary Care Nurse Practitioner
1835254405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376545251
—
UT
Enumeration date
08/11/2005
Last updated
04/30/2024
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