Peggy B Van Dam, RN Valid NPI

Individual provider · Psychiatric/Mental Health Registered Nurse · Midvale, UT

NPI

1053391599

Type

Individual (Type 1)

Primary specialty

Psychiatric/Mental Health Registered Nurse (Registered Nurse)

Specialty group

Nursing Service Providers

Taxonomy code

163WP0808X

License number

208288-3102 (UT)

Sex

Female

Sole proprietor

No

Enumerated

2006-01-19

Last updated

2007-07-08