Individual
NANCY S SENGMANICHANH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
22 S 900 E, SALT LAKE CITY, UT 84102-1307
(801) 328-2522
(801) 533-0589
Mailing address
22 S 900 E, SALT LAKE CITY, UT 84102-1307
(801) 328-2522
(801) 533-0589
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9239171-1206
UT
363AS0400X
Surgical Physician Assistant
9239171-1206
UT
Other
Enumeration date
12/05/2014
Last updated
12/05/2014
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