Individual provider · Type 1 NPI
Marilyn Marie Chan, EDD MSN MED APRN
Pediatric Nurse Practitioner · West Jordan, UT
NPI number
1124175161
Active
Practice location
8925 South 2700 West
West Jordan, UT 84044
Fax (801) 566-7993
Mailing address
3451 S Eastwood Drive
Salt Lake City, UT 84109
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 87-199449-4405 (UT) |
Pediatric Nurse Practitioner: Definition to come...
Other pediatric nurse practitioner providers in West Jordan
About NPI 1124175161
Marilyn Marie Chan, EDD MSN MED APRN's National Provider Identifier is 1124175161, issued on Jan 4, 2007. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in West Jordan, UT. The record was last updated on Jul 8, 2007.