Organization
EDEN FAMILY CARE AND MEDICAL AESTHETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ELIZABETH GARDNER FNP/CNM (NURSE PRACTITIONER/OWNER)
(801) 217-9230
Entity
Organization
Contact information
Practice address
2612 N HIGHWAY 162, EDEN, UT 84310-9745
(801) 217-9230
(801) 217-9230
Mailing address
PO BOX 687, EDEN, UT 84310-0687
(801) 217-9230
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
9758122-4405
UT
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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