Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 8904757-4405 | UT |
NPI | 1023548070 |
---|---|
Provider Name | Sarah Leggett |
First Address | West Jordan, UT 84088-5811 |
Second Address | West Jordan, UT 84088-5811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2017 |
Last Update Date | 29/07/2019 |