Individual
MARLEE GOMM DICRISTOFANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
917 E 1150 N, PLEASANT GROVE, UT 84062-9100
(801) 368-6723
Mailing address
917 E 1150 N, PLEASANT GROVE, UT 84062-9100
(801) 368-6723
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
4826371-3102
UT
163WL0100X
Lactation Consultant (Registered Nurse)
4826371-3102
UT
163WN1003X
Nutrition Support Registered Nurse
4826371-3102
UT
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
4826371-3102
UT
Other
Enumeration date
12/19/2015
Last updated
12/20/2015
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