Individual
STACIE WEEKS MECHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.N.P.
Contact information
Practice address
2380 N 400 E, STE C, NORTH LOGAN, UT 84341-1749
(435) 753-7337
Mailing address
2740 NORTH 1000 EAST, NORTH LOGAN, UT 84341
(435) 512-5610
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2246214405
UT
Other
Enumeration date
05/02/2006
Last updated
12/07/2011
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