Individual
MONIQUE HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
736 S 900 E STE 203, ST GEORGE, UT 84790-7003
(435) 215-0490
(435) 215-0489
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13602984-1206
UT
Other
Enumeration date
06/15/2020
Last updated
05/16/2024
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