Individual
ANNETTE S PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2055 N MAIN ST, TOOELE, UT 84074
(435) 843-3600
Mailing address
PO BOX 268, BOUNTIFUL, UT 84011-0268
(801) 296-2113
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R158002-4
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413162200
—
MN
Enumeration date
02/16/2006
Last updated
03/02/2009
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