Individual
VIKTORYIA PETRUSEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
370 E 9TH AVE STE 101, SALT LAKE CITY, UT 84103-3186
(801) 507-7070
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
14219578-4402
UT
176B00000X
Midwife
—
—
367A00000X
Advanced Practice Midwife
Primary
14219578-4402
UT
Other
Enumeration date
07/10/2018
Last updated
12/11/2025
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