TIA PETERSON NP-C NPI 1902277908

NPI Information

Tia Peterson, NP-C is a family nurse practitioner in Salt Lake City, UT. Tia Peterson, NP-C NPI is 1902277908. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

24 S 1100 E
#201
SALT LAKE CITY, UT
ZIP 84102-500
Phone: (385) 290-1289

The NPI 1902277908 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/15/2015 and was last updated on 5/5/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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