KAYELYNN VAN WAGENEN

SALT LAKE CITY, UT
NPI1215944913
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: UT  2125534405)
Enumeration Date2006-08-02
Last Update Date2007-10-17
Business Address
-- KAYELYNN VAN WAGENEN APRN
400 C ST
SALT LAKE CITY, UT 84143-1005
Phone number: 801-408-5319
Mailing Address
-- KAYELYNN VAN WAGENEN APRN
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: 801-408-5319
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