Individual
HANNAH LOUISE MIKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-2800
Mailing address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-2800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-12562
NC
363AS0400X
Surgical Physician Assistant
Primary
13667672-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/16/2022
Last updated
10/09/2024
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