Individual
MRS. MARYJANE HYDE BOLDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8TH AVE C STREET, LDS HOSPITAL (W7), SALT LAKE CITY, UT 84103
(801) 408-2700
(801) 408-5620
Mailing address
2834 E 4510 S, SALT LAKE CITY, UT 84117-4661
(801) 541-1432
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6686503-4405
UT
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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