Peterson, Clint W

Peterson, Clint W is an individual health care provider with primary practice located at 750 N 200 W , Provo UT 84601-1677. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Peterson, Clint W can be contacted via phone (801) 373-9656.

Contact Information

Primary practice address
750 N 200 W Provo UT 84601-1677
Phone: (801) 373-9656
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 5938005-3102 Utah
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 5938005-4408 Utah

Profile Details

NPI number 1063642510
LBN Legal business name Peterson, Clint W
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2009
Last updated May 27th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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