Individual
MAURICE MANFRED FIEDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
2639 W 13220 S, RIVERTON, UT 84065-2279
(801) 815-2068
Mailing address
2639 W 13220 S, RIVERTON, UT 84065-2279
(801) 815-2068
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
6210942-3102
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6210942-4405
UT
Other
Enumeration date
11/20/2020
Last updated
09/22/2021
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