Individual
MS. MARISSA ANN MASIHDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-6801
Mailing address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
60784832
WA
363L00000X
Nurse Practitioner
Primary
8505124-4405
UT
Other
Enumeration date
03/17/2020
Last updated
08/04/2022
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