Individual
DONNA MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
280 N HOSPITAL DR, STE 3, PRICE, UT 84501-4216
(435) 637-6348
(435) 637-6422
Mailing address
280 N HOSPITAL DR, SUITE 3, PRICE, UT 84501-4216
(435) 637-6348
(435) 637-6422
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2094274405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD8580
PALMETTO GBA- RAILROAD MEDICARE
UT
Enumeration date
06/02/2005
Last updated
05/14/2008
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