Peterson, Travis Dale

Peterson, Travis Dale is an individual health care provider with primary practice located at 1034 N 500 W , Provo UT 84604-3380. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Neonatal, which is considered as his primary health care specialty. Peterson, Travis Dale can be contacted via phone (801) 357-7414.

Contact Information

Primary practice address
1034 N 500 W Provo UT 84604-3380
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Neonatal 363LN0000X 8058003-4405 Utah

Profile Details

NPI number 1467195552
LBN Legal business name Peterson, Travis Dale
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2022
Last updated Jan 9th, 2023 - about last year

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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