Individual
NICOLE GRISE ORGAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2000 CIRCLE OF HOPE, CLINIC 2E, SALT LAKE CITY, UT 84112-5550
(801) 585-0100
(801) 585-3846
Mailing address
127 S 500 E STE 600, SALT LAKE CITY, UT 84102-1971
(801) 587-6705
(801) 715-8228
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
7046321-1206
UT
363AM0700X
Medical Physician Assistant
7046321-8906
UT
Other
Enumeration date
08/03/2006
Last updated
11/10/2021
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