Provider Demographics
NPI:1730828567
Name:DEAN-SMITH, MARI (DNP)
Entity type:Individual
Prefix:
First Name:MARI
Middle Name:
Last Name:DEAN-SMITH
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3967 W UNIONDALE CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-4170
Mailing Address - Country:US
Mailing Address - Phone:801-372-7325
Mailing Address - Fax:
Practice Address - Street 1:3967 W UNIONDALE CT
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84009-4170
Practice Address - Country:US
Practice Address - Phone:801-372-7325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8414672-4402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife