Individual
TINA NACKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
585 N 500 W, PROVO, UT 84601-1548
(801) 404-5588
Mailing address
585 N 500 W, PROVO, UT 84601-1548
(801) 404-5588
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
—
—
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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