Individual
AMANDA RENA MATSUURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
750 ROUND VALLEY DR STE 201, PARK CITY, UT 84060-7549
(435) 649-7680
(435) 776-9353
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10994220-4405
UT
363LF0000X
Family Nurse Practitioner
10994220-4405
UT
Other
Enumeration date
10/08/2018
Last updated
03/31/2026
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