Individual
MARILYN MARIE CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDD MSN MED APRN
Contact information
Practice address
8925 SOUTH 2700 WEST, WEST JORDAN, UT 84044
(801) 566-6200
(801) 566-7993
Mailing address
3451 S EASTWOOD DRIVE, SALT LAKE CITY, UT 84109
(801) 272-2682
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
87-199449-4405
UT
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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