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Individual

JOSEPH AUSTIN CASSIDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN, CPNP-PC

Contact information

Practice address
1912 W 930 N, PLEASANT GROVE, UT 84062-4104
(803) 367-1480
Mailing address
1912 W 930 N, PLEASANT GROVE, UT 84062-4104
(803) 367-1480

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
12445460-3102
UT
163W00000X
Registered Nurse
248472
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
12445460-4405
UT
363LP2300X
Primary Care Nurse Practitioner
12445460-4405
UT

Other

Enumeration date
10/06/2021
Last updated
10/25/2021
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