Individual
DIANE S FEDORCHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
324 10TH AVE STE 163, SALT LAKE CITY, UT 84103-2856
(801) 408-1440
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 408-1440
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
2012884402
UT
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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