Individual
MARSHA K MEDFORD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1165 E 300 N, WASATCH MENTAL HEALTH, YOUTH OUTPATIENT, PROVO, UT 84606-3539
(801) 377-1213
(801) 356-2703
Mailing address
259 S 500 E, PROVO, UT 84606-4731
(801) 377-1213
(801) 356-2703
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5376965-4405
UT
Other
Enumeration date
02/22/2006
Last updated
07/08/2007
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