Individual
MARILYN B WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2121 N 1700 W, LAYTON, UT 84041-8803
(801) 773-4840
(801) 525-8151
Mailing address
PO BOX 337, LAYTON, UT 84041-0337
(801) 773-4840
(801) 525-8151
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
215309-4405
UT
363LF0000X
Family Nurse Practitioner
215309-4405
UT
Other
Enumeration date
08/08/2006
Last updated
12/04/2019
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