Southwick, Martha Fern

Southwick, Martha Fern is an individual health care provider with primary practice located at 8541 S Redwood Rd Ste C2 , West Jordan UT 84088. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Southwick, Martha Fern can be contacted via phone (801) 432-7712.

Contact Information

Primary practice address
8541 S Redwood Rd Ste C2 West Jordan UT 84088
Phone: (801) 432-7712
Fax: (866) 817-1629
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2000204405 Utah

Profile Details

NPI number 1568685550
LBN Legal business name Southwick, Martha Fern
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2007
Last updated Jun 6th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1568685550 NPPES
Utah MEDICAID 1017129

Popular Providers