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Individual

NATASHA NICOLLE PETERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
STAT MD, 1784 UINTA WAY E, PARK CITY, UT 84098
(435) 604-0160
Mailing address
3741 S CANLEY VALE CT, SALT LAKE CITY, UT 84115-3131
(801) 699-6656

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8454365-4405
UT

Other

Enumeration date
02/19/2019
Last updated
12/20/2021
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