Healthcare Provider Details

I. General information

NPI: 1346931011
Provider Name (Legal Business Name): CORRINNE ERICKSON UVEJZOVIC CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 N 500 W
PROVO UT
84601-1548
US

IV. Provider business mailing address

585 N 500 W
PROVO UT
84601-1548
US

V. Phone/Fax

Practice location:
  • Phone: 801-374-1801
  • Fax: 801-216-8357
Mailing address:
  • Phone: 801-374-1801
  • Fax: 801-216-8357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number262376-4402
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number262376-4402
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: