Organization
BLUE SAGE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA COCCIMIGLIO NP (AGPCNP)
(801) 718-7280
Entity
Organization
Contact information
Practice address
6300 SAGEWOOD DR, SUITE H-532, PARK CITY, UT 84098-7502
(801) 718-7280
(888) 853-5162
Mailing address
6300 SAGEWOOD DR, SUITE H-532, PARK CITY, UT 84098-7502
(801) 718-7280
(888) 853-5162
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
123071-4405
UT
Other
Enumeration date
03/22/2016
Last updated
08/29/2017
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