Search › Utah › 183500000X
Nina Ivanova
NPI 1417559451 · on the registry since 2020 · sole proprietor
Practice
- Address
- 6545 N Landmark Dr
Park City, UT 84098 - Phone
- (435) 647-9040
- Fax
- (435) 647-9042
- Organisation at this address
- Walmart Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-11-13
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