Individual
TYRA HEPWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3661 E SPRUCE DR, SALT LAKE CITY, UT 84124-3857
(801) 628-5590
Mailing address
3661 E SPRUCE DR, SALT LAKE CITY, UT 84124-3857
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
9811198-3102
UT
Other
Enumeration date
08/21/2020
Last updated
08/21/2020
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