Individual
MARY MARTHA ATIEE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
550 N MAIN ST, SUITE 117, LOGAN, UT 84321-3983
(435) 753-0724
Mailing address
919 MILESTONE DR, SMITHFIELD, UT 84335-2552
(435) 563-0365
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
5658728-4405
UT
Other
Enumeration date
02/14/2006
Last updated
07/08/2007
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