Individual
SIERRA C MCQUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
6360 S 3000 E, STE 100, SALT LAKE CITY, UT 84121-6923
(801) 365-1032
(801) 365-1036
Mailing address
2295 FOOTHILL DR, SALT LAKE CITY, UT 84109-4000
(801) 486-3021
(801) 485-6339
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8123867-1206
UTAH STATE LICENSE
UT
Enumeration date
10/19/2010
Last updated
11/20/2021
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