Individual
MAREN VANWAGONER FERRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1455 E QUAIL STREAM LN, COTTONWOOD HEIGHTS, UT 84093
(520) 123-4567
Mailing address
1455 E QUAIL STREAM LN, COTTONWOOD HEIGHTS, UT 84093-6106
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP4973
AZ
Other
Enumeration date
01/22/2020
Last updated
06/05/2020
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