Individual
DEEANN CERVANTEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 N MARIO CAPECCHI DR STE 3550, SALT LAKE CITY, UT 84113-1103
(801) 662-5555
Mailing address
100 N MARIO CAPECCHI DR STE 3550, SALT LAKE CITY, UT 84113-1103
(801) 662-5555
(801) 662-5547
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
108619-4405
UT
363LP0200X
Pediatric Nurse Practitioner
Primary
108619-4405
UT
Other
Enumeration date
01/03/2018
Last updated
11/11/2021
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