Individual
TINA R HADLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN.
Contact information
Practice address
6822 E 1000 S, FT, DUCHESNE, UT 84026-0160
(435) 722-5122
Mailing address
PO BOX 252, ROOSEVELT, UT 84066-0252
(435) 722-5122
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
196798-3102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196798-3102
REGISTERED NURSE
UT
Enumeration date
05/31/2007
Last updated
07/08/2007
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