Healthcare Provider Details

I. General information

NPI: 1649041039
Provider Name (Legal Business Name): SIERRA CLAUDIA PETERSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 E RIVERSIDE DR STE 202
ST GEORGE UT
84790-7125
US

IV. Provider business mailing address

393 E RIVERSIDE DR STE 202
ST GEORGE UT
84790-7125
US

V. Phone/Fax

Practice location:
  • Phone: 435-572-0795
  • Fax:
Mailing address:
  • Phone: 435-572-0795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11291667-8900
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11291667-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: