Provider Demographics
NPI:1457109027
Name:GEFEN, MAAIAN (RN, DEM)
Entity type:Individual
Prefix:
First Name:MAAIAN
Middle Name:
Last Name:GEFEN
Suffix:
Gender:F
Credentials:RN, DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3608 EASTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-3809
Mailing Address - Country:US
Mailing Address - Phone:801-884-2035
Mailing Address - Fax:
Practice Address - Street 1:826 E 12300 S
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8276
Practice Address - Country:US
Practice Address - Phone:801-252-6243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay