| Doctor Name: | MRS. DONNA MARY FENRICH |
| NPI Number: | 1053400697 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHYSICIAN ASSISTANT |
| License Number: | 5951647-1206 |
| Business Practice Address: | 441 Bowden St Sandy, UT - 840705408 |
| Business Phone Number: | 8018288094 |
| Business Fax Number: | |
| Mailing Address: | 441 Bowden St, SANDY |
| State: | UT |
| Postal Code: | 840705408 |
| Phone Number: | 8018288094 |
| Fax Number: | |
| NPI Enumeration Date: | 10/12/2006 |
| NPI Last Update Date: | 09/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 5951647-1206 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |