Individual
CHEROKEE CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4095 E PONY EXPRESS PARKWAY, EAGLE MOUNTAIN, UT 84005
(801) 429-8037
(801) 753-7476
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604-1246
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11583503-1206
UT
363A00000X
Physician Assistant
PA61242297
WA
Other
Enumeration date
01/15/2020
Last updated
01/02/2024
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