Individual
MR. SAMUEL B VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.P.R.N.
Contact information
Practice address
404 S 400 W, SALT LAKE CITY, UT 84101-2201
(801) 364-0058
Mailing address
8739 IDA LN, SANDY, UT 84093-1417
(801) 566-2122
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
48286343102
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4828634-4405
UT
Other
Enumeration date
08/05/2007
Last updated
10/30/2009
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