Individual
LEILANI FIFITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1157 S REDWOOD DR, SALT LAKE CITY, UT 84104-3328
(385) 528-9143
Mailing address
1157 S REDWOOD DR, SALT LAKE CITY, UT 84104-3328
(385) 528-9143
Taxonomy
Speciality
Code
Description
License number
State
364SH0200X
Home Health Clinical Nurse Specialist
Primary
LIC201801499
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LIC201801499
—
UT
Enumeration date
06/28/2018
Last updated
06/28/2018
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