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Individual

ELAINE E ARCHULETA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
5405 S 500 E STE 204, OGDEN, UT 84405-7420
(801) 479-0184
(801) 479-5642
Mailing address
PO BOX 741729, ATLANTA, GA 30374-1729

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
222610-4405
UT
363L00000X
Nurse Practitioner
Primary
2226104405
UT

Other

Enumeration date
11/17/2006
Last updated
01/26/2022
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