Individual
GABRIEL PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
CRNA
Contact information
Practice address
1836 E SUNNYSIDE AVE, SALT LAKE CITY, UT 84108-1345
(801) 690-4758
Mailing address
1836 E SUNNYSIDE AVE, SALT LAKE CITY, UT 84108-1345
(801) 690-4758
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
13133952-3102
UT
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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