| |
1397 W Sunset Blvd Ste 109, St George, UT 84770-4212 | |
(435) 862-0125 | |
(435) 215-7680 |
Full Name | |
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Type | Facility |
Speciality | Nurse Practitioner - Primary Care |
Location | 1397 W Sunset Blvd Ste 109, St George, Utah |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831626993 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 8328842-1202 (Utah) | Secondary |
363LP2300X | Nurse Practitioner - Primary Care | 5322635-4405 (Utah) | Primary |
Provider Name | Orbie T Davis |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1053453191 PECOS PAC ID: 5597677021 Enrollment ID: I20130731000690 |
Provider Name | Steffanie Peterson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083969455 PECOS PAC ID: 5597992560 Enrollment ID: I20131219000166 |
Mailing Address | Practice Location Address |
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1397 W Sunset Blvd Ste 109, St George, UT 84770-4212 Ph: (435) 862-0125 | 1397 W Sunset Blvd Ste 109, St George, UT 84770-4212 Ph: (435) 862-0125 |