Individual
NANCY W. MORTENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N.
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-8200
(801) 357-8201
Mailing address
1121 E 3900 S, SUITE C-240, SALT LAKE CITY, UT 84124-1214
(801) 266-0878
(801) 266-2074
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
220619-4405
UT
Other
Enumeration date
05/10/2006
Last updated
09/02/2010
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