Individual
NANCY PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1140 E 3900 S STE 340, SALT LAKE CITY, UT 84124-1244
(801) 268-7479
(801) 268-7622
Mailing address
PO BOX 742382, ATLANTA, GA 30374-2382
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95129038
CA
363L00000X
Nurse Practitioner
12494827-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
12494827-4405
UT
363LF0000X
Family Nurse Practitioner
202211106NP-PP
OR
363LF0000X
Family Nurse Practitioner
95007201
CA
Other
Enumeration date
06/20/2017
Last updated
08/12/2024
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