Individual
TAYLOR LOLA SUBLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHDNP
Contact information
Practice address
845 E 4800 S, MURRAY, UT 84107-5049
(801) 264-9522
Mailing address
845 E 4800 S, MURRAY, UT 84107-5049
(801) 264-9522
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
9805840-8900
UT
Other
Enumeration date
08/11/2021
Last updated
11/09/2022
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