Individual
MS. LAURIE ANN VONDERAHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2745
Mailing address
1286 MORAY CT, PARK CITY, UT 84060-6901
(435) 647-5770
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
198615-4405
UT
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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