Individual
DUSTIN COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 S 2000 E, SALT LAKE CITY, UT 84112-5880
(801) 581-3414
Mailing address
4088 W 1820 S, SALT LAKE CITY, UT 84104-4885
(801) 975-7799
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
76505773102
UT
363LF0000X
Family Nurse Practitioner
Primary
7650577-4405
UT
Other
Enumeration date
06/02/2020
Last updated
09/30/2021
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