Dr. Caitlin Gannon Peterson
Pediatric Nephrologist
100 N Mario Capecchi Dr
Salt Lake City
, Utah 84113-1103
Dr. Caitlin Gannon Peterson
Pediatric Nephrologist
100 N Mario Capecchi Dr
Salt Lake City
, Utah 84113-1103
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About
Features
Specialties
- Pediatric Nephrologist
Languages spoken
- English
Location
First Address
- Dr. Caitlin Gannon Peterson
- Po Box 30180
- Salt Lake City, UT
- Zip : 84130-0180
- Phone :
Second Address
- Dr. Caitlin Gannon Peterson
- 100 N Mario Capecchi Dr
- Salt Lake City, UT
- Zip : 84113-1103
- Phone : (801) 662-1000
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Is Dr. Caitlin Gannon Peterson a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0210X | Pediatric Nephrologist | 10784090-1204 | UT |
National Provider Identifier
| NPI | 1760742530 |
|---|---|
| Provider Name | Dr. Caitlin Gannon Peterson |
| First Address | Salt Lake City, UT 84130-0180 |
| Second Address | Salt Lake City, UT 84113-1103 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/05/2012 |
| Last Update Date | 11/11/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.