Soutsada Konesavanh, PA-C

NPI 1417108606 · on the registry since 2008 · sole proprietor

Practice

Address: 100 Mario Capecchi Dr
Salt Lake City, UT 84112
Phone: (801) 585-2341
Organisation at this address: Pediatric Allergy
Pediatric Pm And R
Ihc Health Services Inc
Ihc Health Services Inc
Intermountain Healthcare
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 185

Registry record

Primary taxonomy: 363AM0700X
363AM0700X
Also registered as: 363A00000X
Licence states on file: UT
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2021-11-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah