Individual
PEGGY MARIA BODAMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5475 S 500 E, OGDEN, UT 84405-6905
(801) 479-2560
(801) 479-2995
Mailing address
5475 S 500 E, OGDEN, UT 84405-6905
(801) 479-2560
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
Primary
7337054-3102
UT
363LN0000X
Neonatal Nurse Practitioner
73370543102
UT
Other
Enumeration date
09/11/2020
Last updated
09/15/2020
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