Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 11203469-4405 | UT |
NPI | 1073168761 |
---|---|
Provider Name | Mrs. Sarah Elizabeth Williams |
First Address | Cottonwood Heights, UT 84121-7209 |
Second Address | Salt Lake City, UT 84113-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2019 |
Last Update Date | 08/08/2019 |