Individual
MRS. LISA PROUDLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1169 S 2130 E, SPANISH FORK, UT 84660-5526
(801) 400-1885
Mailing address
1169 S 2130 E, SPANISH FORK, UT 84660-5526
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13211996-4405
UT
Other
Enumeration date
12/25/2025
Last updated
12/25/2025
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