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Individual

TARA LEE UDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
585 N 500 W, PROVO, UT 84601-1548
(801) 374-1801
(801) 216-8357
Mailing address
884 W 225 S, SPRINGVILLE, UT 84663-5533
(801) 857-1396

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10879383-4405
UT
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
10879383
UT

Other

Enumeration date
10/19/2022
Last updated
09/21/2023
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