Individual
MR. GLENDON ARLY PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
440 N PAIUTE DR, CEDAR CITY, UT 84721-6181
(435) 867-1520
(435) 867-2658
Mailing address
440 N PAIUTE DR, CEDAR CITY, UT 84721-6181
(435) 867-1520
(435) 867-1520
Taxonomy
Speciality
Code
Description
License number
State
247000000X
Health Information Technician
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
5581789-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5581789-4405
UTAH STATE LICENSE
UT
Enumeration date
05/02/2011
Last updated
06/08/2023
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