Individual
MICHELLE AMANDA HARLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-3577
(801) 662-3588
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
8372920-4405
UT
Other
Enumeration date
04/19/2023
Last updated
08/03/2023
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