Healthcare Provider Details

I. General information

NPI: 1801878558
Provider Name (Legal Business Name): NANNETTE AMES SAGESER PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 FOOTHILL DR SUITE 301
SALT LAKE CITY UT
84112-1106
US

IV. Provider business mailing address

165 LOWER EVERGREEN DR
PARK CITY UT
84098-5252
US

V. Phone/Fax

Practice location:
  • Phone: 801-585-5385
  • Fax: 801-585-5393
Mailing address:
  • Phone: 435-940-0249
  • Fax: 801-585-5393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number151670-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: