Provider Demographics
NPI:1801878558
Name:SAGESER, NANNETTE AMES (PHARMD)
Entity type:Individual
Prefix:
First Name:NANNETTE
Middle Name:AMES
Last Name:SAGESER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:165 LOWER EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-5252
Mailing Address - Country:US
Mailing Address - Phone:435-940-0249
Mailing Address - Fax:801-585-5393
Practice Address - Street 1:555 FOOTHILL DR
Practice Address - Street 2:SUITE 301
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-1106
Practice Address - Country:US
Practice Address - Phone:801-585-5385
Practice Address - Fax:801-585-5393
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT151670-17011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy