Individual
ANIKA VAN BOERUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1840 S 1300 E, SALT LAKE CITY, UT 84105-3697
(801) 832-2200
Mailing address
1840 S 1300 E, SALT LAKE CITY, UT 84105-3697
(801) 832-2200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11601554-4405
UT
Other
Enumeration date
04/18/2023
Last updated
10/04/2024
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