Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SOUTSADA NIKKI KONESAVANH, PA-C
Active Sole ProprietorSOUTSADA NIKKI KONESAVANH, PA-C is a Medical Physician Assistant healthcare provider located in SALT LAKE CITY, Utah. NPI 1417108606 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · SALT LAKE CITY, UT
Registration Details
- NPI Number
- 1417108606
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 6, 2008 (17.846417464253 yrs)
- Last Updated
- Nov 17, 2021
- Licenses
-
7138480-1206 (UT)7138480-1206 (UT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
100 MARIO CAPECCHI DRSALT LAKE CITY, UT, 841128924Browse UT providers · Browse ZIP 84112
- Phone
- 8015852341
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
- Additional Specialty
- Medical Physician Assistant
Other Medical Physician Assistant Providers in SALT LAKE CITY, UT
| Name | Credential | NPI |
|---|---|---|
| MARGARET MICHELE LOVELL | PA | 1922093558 |
| MICHAEL DAVID ENGELBERT-FENTON | PA-C | 1194701920 |
| MR. DAVID JOE KEAHEY | PA-C | 1003892837 |
| VIET LE | PAC | 1669440152 |
| LOUISE K TOBEY | PA-C | 1841252004 |
| CHARLES S KING | PA | 1740235845 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.