Elizabeth Maria Durham, Nurse Practitioner
Nurse Practitioner, Family in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1104580356
StatusActive
Last updated in NPPESJun 15, 2022
Details
- NPI
- 1104580356
- Entity type
- Individual (NPI-1)
- Name
- Elizabeth Maria Durham
- Credential
- Nurse Practitioner
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 25, 2021
- Certification date
- Jun 15, 2022
- Last updated
- Jun 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 7081449-4405 | UT | Yes |
Practice location
324 E 10th Ave Ste 100Salt Lake City, UT 84103-2870
Phone 801-408-7500
Mailing address
Po Box 27128Salt Lake City, UT 84127-0128
Phone 801-408-7500
Other practice locations
25 Rollingwood Ln
Sandy, UT 84092-4803
Sandy, UT 84092-4803
Phone 802-302-9171
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