Provider Demographics
NPI:1992985535
Name:VEASY, CARLOTTA KAY (FNP-C)
Entity type:Individual
Prefix:MS
First Name:CARLOTTA
Middle Name:KAY
Last Name:VEASY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4755 WANDER LN
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5459
Mailing Address - Country:US
Mailing Address - Phone:801-550-5086
Mailing Address - Fax:
Practice Address - Street 1:5292 COLLEGE DR
Practice Address - Street 2:SUITE 302
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-2672
Practice Address - Country:US
Practice Address - Phone:801-550-5086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT208714-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily