Individual
VANESA NICOL CANNON JUDD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
893 E 9400 S, SANDY, UT 84094-3671
(385) 335-7862
Mailing address
194 E ALPINE TRAIL DR, DRAPER, UT 84020-4507
(385) 312-3828
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
96056983102
UT
Other
Enumeration date
07/24/2023
Last updated
07/24/2023
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