Most Relevant Information
Provider Data
| NPI Number: | 1003396532 |
| Provider Name: | NANETTE EDITH MOOSMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/15/2018 |
| Last Updated: | 08/15/2018 |
Provider Practice Location
344 E 100 S STE 301
SALT LAKE CITY
UT
841111727
Practice Location Phone/Fax
| Phone: | 8014284257 |
| Fax: |
Provider Mailing Location
344 E 100 S STE 301
SALT LAKE CITY
UT
841111727
Provider Mailing Phone/Fax
| Phone: | 8014284257 |
| Fax: |