Individual
EASTON ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4403 HARRISON BLVD STE 1670, OGDEN, UT 84403-3306
(801) 387-7150
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9256356-3102
UT
363L00000X
Nurse Practitioner
9256356-4405
UT
363LA2100X
Acute Care Nurse Practitioner
Primary
9256356-4405
UT
Other
Enumeration date
02/05/2025
Last updated
12/03/2025
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