Individual
MS. PEGGY GRUSENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1300 E CENTER ST, PROVO, UT 84606-3554
(801) 344-4204
(801) 344-4291
Mailing address
1300 E CENTER ST, PROVO, UT 84606-3554
(801) 344-4204
(801) 344-4291
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2057812073
UT
Other
Enumeration date
06/24/2009
Last updated
06/24/2009
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