Maria Christina Paegle, APRN

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Salt Lake City, UT

NPI 1124237011 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124237011
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
4741912-4405 (UT)
Practice address
4659 Brookwood Dr
Salt Lake City, UT 84117-4909
Phone
(801) 268-9038
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4741912-4405UTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Behavioral Health Incorporated Psychiatric/Mental Health Past Accepting new patients
Valley Mental Health Incorporated Psychiatric/Mental Health Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4741912-4405 UT Yes

Addresses

Primary practice location

4659 Brookwood Dr
Salt Lake City, UT 84117-4909

Mailing address

4659 Brookwood Dr
Salt Lake City, UT 84117-4909
Phone (801) 268-9038

Other providers in Salt Lake City, UT

All providers in Salt Lake City, UT · Psychiatric/Mental Health Nurse Practitioner in Utah

Sources for this page

Verify at the official NPI Registry.