Individual
CYNTHIA PHYLLIS WASEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4376 S 700 E STE 200, SALT LAKE CITY, UT 84107-3077
(385) 272-4292
(866) 855-3582
Mailing address
2204 E 3715 S, SALT LAKE CITY, UT 84109-3338
(801) 824-2185
(866) 855-3582
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2001478900
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952398737
—
UT
Enumeration date
10/05/2005
Last updated
05/14/2025
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