Individual
ALYSSA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6599 W YAWKEY WAY, HERRIMAN, UT 84096-2976
(509) 551-9420
Mailing address
6599 W YAWKEY WAY, HERRIMAN, UT 84096-2976
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95219163102
UT
363L00000X
Nurse Practitioner
9521916-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
9521916-4405
UT
Other
Enumeration date
02/25/2025
Last updated
03/11/2026
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