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Individual

DALLAS LANE EARNSHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN, CNS, BC

Contact information

Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
212165-4405
UT

Other

Enumeration date
10/02/2006
Last updated
07/08/2007
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