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Organization

PAMELA L. VINCENT MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAMELA VINCENT MD (PRESIDENT)
(801) 229-1014
Entity
Organization

Contact information

Practice address
3152 N UNIVERSITY AVE STE 220, PROVO, UT 84604-4746
(801) 229-1014
(801) 229-1067
Mailing address
3152 N UNIVERSITY AVE STE 220, PROVO, UT 84604-4746
(801) 229-1014
(801) 229-1067

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
2084N0400X
Neurology Physician
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
09/21/2015
Last updated
09/21/2015
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