Healthcare Provider Details

I. General information

NPI: 1205355450
Provider Name (Legal Business Name): MALIA BASCOM STRINGHAM PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2017
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 N VERNAL AVE STE 1
VERNAL UT
84078-2100
US

IV. Provider business mailing address

PO BOX 111 2342 SR-149
JENSEN UT
84035-0111
US

V. Phone/Fax

Practice location:
  • Phone: 435-200-5685
  • Fax: 435-938-7274
Mailing address:
  • Phone: 435-828-7828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number8268095-8900
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: