Organization · Type 2 NPI
Wholelife Family Wellness Clinic of Providence PLLC
Family Nurse Practitioner · Providence, UT
NPI number
1962049932
Active
Practice location
169 N Gateway Dr. Suite 170
Providence, UT 84332
Mailing address
274 N Main St
Logan, UT 84321-3915
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | None listed |
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
About NPI 1962049932
Wholelife Family Wellness Clinic of Providence PLLC's National Provider Identifier is 1962049932, issued on Dec 9, 2019. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Providence, UT. The record was last updated on Mar 13, 2020.