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Individual

MARY LESLIE ROHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-C

Contact information

Practice address
1128 UNIVERSITY CIR, STUDENT SERVICE CENTER 190, OGDEN, UT 84408-1128
(801) 626-6459
(801) 626-7786
Mailing address
1128 UNIVERSITY CIR, STUDENT SERVICE CENTER 190, OGDEN, UT 84408-1128
(801) 626-6459
(801) 626-7786

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2244504405
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32481
UT
05
876000308011
UT
05
998877666002
UT
Enumeration date
07/16/2008
Last updated
07/02/2010
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