Individual
LAURA KIANE BLACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1525 E 6000 S, SOUTH OGDEN, UT 84405-7144
(801) 337-5800
(801) 337-5809
Mailing address
3450 HIDDEN MEADOW CIR, MOUNTAIN GREEN, UT 84050-6743
(801) 645-0671
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
377805-4405
UT
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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