Individual
MINA L WAYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
152 S 4TH ST, MONTPELIER, ID 83254-1538
(435) 755-6061
Mailing address
517 W 100 N STE 210, PROVIDENCE, UT 84332-9826
(435) 755-6061
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
207247-4405
UT
Other
Enumeration date
01/04/2008
Last updated
07/12/2019
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