Individual
TAMARA JEAN EWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1055 N 300 W STE 311, PROVO, UT 84604-3373
(801) 852-9601
Mailing address
1521 EASTWOOD CIR, PRICE, UT 84501-2036
(435) 630-3951
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5645425-4405
UT
Other
Enumeration date
05/15/2024
Last updated
05/15/2024
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