PENNY J MADER

PROVO, UT
NPI1518247758
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: UT  13327156-4405)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: NM  CNP-01828)
Enumeration Date2011-08-19
Last Update Date2023-05-24
Business Address
PENNY J MADER CNP
1055 N 500 W ATTN CREDENTIALING
PROVO, UT 84604
Phone number: 801-354-8225
Mailing Address
PENNY J MADER CNP
1055 N 500 W ATTN CREDENTIALING
PROVO, UT 84604-4232
Phone number: 801-354-8225