Individual
PEYTON RUSTY COOMBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
775 S MAIN ST STE A, LOGAN, UT 84321-5402
(435) 562-3133
Mailing address
1678 E 1700 N, LOGAN, UT 84341-2146
(801) 928-9020
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9646747-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
14160393-4405
UT
Other
Enumeration date
12/11/2023
Last updated
09/10/2024
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