Individual
FIAAVAE BETTY PATANE-LAITITI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
714 S STATE ST, OREM, UT 84058-6366
(801) 426-6565
Mailing address
4682 E FOXWOOD DR, EAGLE MOUNTAIN, UT 84005-6176
(801) 500-7912
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10068111-3101
UT
Other
Enumeration date
11/10/2021
Last updated
11/10/2021
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