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Individual

ALLISON BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
12351 S GATEWAY PARK PL STE D-700, DRAPER, UT 84020-9581
(801) 970-3676
Mailing address
12351 S GATEWAY PARK PL STE D-700, DRAPER, UT 84020-9581
(801) 970-3676

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
5921723-3102
UT

Other

Enumeration date
09/23/2021
Last updated
09/23/2021
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