Individual
NICOLE C PEZELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3809 W 6200 S, TAYLORSVILLE, UT 84129-3725
(801) 963-4360
Mailing address
4460 S HIGHLAND DR, SALT LAKE CITY, UT 84124-3543
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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