Provider Demographics
NPI:1053302406
Name:KATOMSKI, ELIZABETH MARY (RN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARY
Last Name:KATOMSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 BLAINE AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3802
Mailing Address - Country:US
Mailing Address - Phone:801-486-6330
Mailing Address - Fax:
Practice Address - Street 1:550 W 700 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84101-2227
Practice Address - Country:US
Practice Address - Phone:801-537-7537
Practice Address - Fax:801-363-3140
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2759003102163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health