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Travis Dale Peterson, RN
Neonatal Nurse Practitioner in Provo, Utah
NPI 1467195552

Travis Dale Peterson is a Neonatal Nurse Practitioner based in Salt Lake City, UT and is specialized in Neonatal. Travis Dale Peterson practices in Provo, UT and has the professional credentials of RN. The NPI Number for Travis Dale Peterson is 1467195552 and holds a License No. 8058003-4405 (Utah).

The current practice location address for Travis Dale Peterson is 1034 N 500 W, Provo, UT and can be reached out via phone at 801-357-7414.

Location: 1034 N 500 W, Provo, UT, 84127-0128
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467195552
Provider Name
Travis Dale Peterson
Credential
RN
Provider Entity Type
Individual
Gender
Male
Address
1034 N 500 W, Provo, UT, 84127-0128
Phone Number
801-357-7414
Fax Number
Provider Enumeration Date
04/15/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1034 N 500 W
City
Provo
State
Utah
Zip
84604-3380
Phone Number
801-357-7414
Fax Number
person
Provider Business Mailing Address Details
Address
1034 N 500 W
City
Provo
State
Utah
Zip
84604-3380
Phone Number
801-357-7414
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Neonatal
Taxonomy
363LN0000X
License No.
8058003-4405 (Utah)
Definition
Definition to come...
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