Doctor Name: | LAURA A PEXTON |
NPI Number: | 1215220785 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | 265220-4405 |
Business Practice Address: | 8446 S Harrison St Midvale, UT - 840473501 |
Business Phone Number: | 8014170131 |
Business Fax Number: | 8012555814 |
Mailing Address: | 8446 S Harrison St, MIDVALE |
State: | UT |
Postal Code: | 840473501 |
Phone Number: | 8014170131 |
Fax Number: | 8012555814 |
NPI Enumeration Date: | 05/17/2011 |
NPI Last Update Date: | 11/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 265220-4405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |