Individual
MITZI JEAN FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
852 W TIMBER CREEK WAY APT 920, SOUTH SALT LAKE, UT 84119-6472
(435) 757-2170
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
7204486-3102
UT
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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