IndividualActive
Danielle Petersen
NPI 1700548328 · Community Health Worker · Provo, UT
Provider details
- NPI number
- 1700548328
- Entity type
- Individual
- Primary specialty
- Community Health WorkerOther Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
1726 S Buckley Ln
Provo, UT 84606-5031
Phone: (801) 373-6562
Fax: (801) 375-9225
Approximate (ZIP-level) locationGet directions
Mailing address
1726 S Buckley Ln
Provo, UT 84606-5031
Registry dates
- Enumerated
- 2021-10-11
- Last updated
- 2021-10-11
- Certified
- 2021-10-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.