Organization
SLIM & TRIM MEDICAL ONLINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CIJA HAUVER NP (PROVIDER)
(435) 554-8637
Entity
Organization
Contact information
Practice address
2400 S COBBLE TER, MENDON, UT 84325-9756
(435) 554-8637
Mailing address
PO BOX 308, MENDON, UT 84325-0308
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12369693-4405
DIVISION OF OCCUPATIONAL AND PROFESSIONAL LICENSING
UT
01
—
202204361NP-PP
BOARD OF NURSING
OR
01
—
66272
BOARD OF NURSING
ID
Enumeration date
04/18/2023
Last updated
04/18/2023
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