Most Relevant Information
Provider Data
| NPI Number: | 1003483207 |
| Provider Name: | MADELINE ANN THAYER NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0200X |
| Specialty: | Nurse Practitioner |
| License Number: | 10122671-4405 |
Most Important Dates
| Enumeration Date: | 06/07/2021 |
| Last Updated: | 07/30/2024 |
Provider Practice Location
100 N MARIO CAPECCHI DR
SALT LAKE CITY
UT
841131103
Practice Location Phone/Fax
| Phone: | 8016623600 |
| Fax: |
Provider Mailing Location
1538 S 400 E
SALT LAKE CITY
UT
841151752
Provider Mailing Phone/Fax
| Phone: | 9702271362 |
| Fax: |