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NPI Code Detail

MEDICARE: JUDIE FE GUZMAN PA-C

MEDICARE: JUDIE FE GUZMAN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant370264-1206UT

General Provider Information

NPI Number : 1992925853
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDIE FE GUZMAN PA-C
Provider Business Mailing Address
First Line : 1379 SETTLEMENT DR
Second Line :
City : PARK CITY
State : UT
Zip : 84098-6566
Country : US
Telephone Number : 801-501-5300
Fax Number : 801-501-5350
Provider Business Practice Location Address
First Line : 4252 S HIGHLAND DR STE 200
Second Line :
City : HOLLADAY
State : UT
Zip : 84124-2690
Country : US
Telephone Number : 801-993-1800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2007
Last Update Date : 07/28/2021

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Directions to “ JUDIE FE GUZMAN PA-C” Practice Location

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