Healthcare Provider Details

I. General information

NPI: 1275457251
Provider Name (Legal Business Name): LAURA PALMER PETERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

697 W 4170 S
MURRAY UT
84123-1326
US

IV. Provider business mailing address

1776 N 300 E UNIT 103
NORTH OGDEN UT
84414-2091
US

V. Phone/Fax

Practice location:
  • Phone: 701-500-9090
  • Fax:
Mailing address:
  • Phone: 701-500-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number14027546-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: