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NPI Profile for STACIE W MECHAM in NORTH LOGAN, UT.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatrics |
363LP0200X | 50 | Nurse Practitioner |
| NPI # | 1598723470 |
|
| Status | Active | |
| Credentials | P.N.P. | |
| Entity | Individual | |
| Enumeration date | 05/02/2006 | |
| Last updated | 12/07/2011 - About 15 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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STACIE W MECHAM
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STACIE W MECHAM, P.N.P.