Provider Demographics
NPI:1033578141
Name:TOLLSTRUP, SARA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:TOLLSTRUP
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 1:675 S ARAPEEN DR STE 205
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1226
Mailing Address - Country:US
Mailing Address - Phone:801-581-3834
Mailing Address - Fax:
Practice Address - Street 1:675 S ARAPEEN DR STE 205
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1226
Practice Address - Country:US
Practice Address - Phone:801-581-3834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7338078-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily