Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 9492401-4405 | UT |
N | 207VX0000X | Obstetrician | 9492401-4402 | UT |
NPI | 1093312183 |
---|---|
Provider Name | Cherysh Hubbard Stock |
First Address | Taylorsville, UT 84123-5208 |
Second Address | Murray, UT 84107-5701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2020 |
Last Update Date | 02/10/2020 |