Individual
SAMANTHA MICHELLE PRIMAVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP-BC
Contact information
Practice address
9280 S SHAD LN, SANDY, UT 84093-2668
(801) 502-3166
Mailing address
9280 S SHAD LN, SANDY, UT 84093-2668
(801) 502-3166
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
6217771-3102
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6217771-4405
UT
Other
Enumeration date
09/21/2024
Last updated
05/14/2026
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