Individual
LISA PETERSON STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4460 S HIGHLAND DR STE 210, SALT LAKE CITY, UT 84124-3550
(888) 949-4864
Mailing address
4460 S HIGHLAND DR STE 210, SALT LAKE CITY, UT 84124-3550
(888) 949-4864
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
8739478-3102
UT
363LF0000X
Family Nurse Practitioner
Primary
8739478-4405
UT
Other
Enumeration date
10/14/2019
Last updated
12/11/2019
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