Individual
MRS. ALLI BASCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3585 N UNIVERSITY AVE STE 250, PROVO, UT 84604-6622
(801) 459-7147
Mailing address
355 S 1200 W, OREM, UT 84058-5150
(801) 358-2149
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8536735-4405
UT
Other
Enumeration date
10/11/2022
Last updated
07/16/2024
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