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Contact Information

GWEN LATENDRESSE, CNM, PHD
10 S 2000 E
ROOM 448
SALT LAKE CITY, UT84112-5880
 Phone: 801-587-9636
 Fax: 801-587-9838
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Advanced Practice Midwife

367A00000X 42 Certified Nurse Midwife
Indicates primary specialty

NPI Profile & details for GWEN LATENDRESSE · (Female)

NPI # 1629226808
Status Active
Credentials CNM, PHD
Entity Individual
Enumeration date 08/30/2008
Last updated 08/30/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 95-216631-4402
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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