Individual
DAYNE TATTERSALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-8524
(801) 584-1205
Mailing address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 718-6324
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
8588367-4405
UT
Other
Enumeration date
07/06/2020
Last updated
04/13/2023
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