Individual
MEGAN E KONOPACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8530 S 500 W, PARADISE, UT 84328-7701
(435) 938-6125
Mailing address
175 E 100 N # B, LOGAN, UT 84321-4601
(435) 755-0439
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12769250-4405
UT
Other
Enumeration date
04/20/2022
Last updated
04/20/2022
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