Individual
MICHELLE LORRAINE TEASDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3415 S 900 W, SOUTH SALT LAKE, UT 84119-4103
(385) 468-8400
Mailing address
4393 N SHADY HOLLOW LOOP, LEHI, UT 84043-2343
(801) 349-6249
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5906820-4405
UT
Other
Enumeration date
07/06/2021
Last updated
07/06/2021
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