| NPI | 1538803978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE KIMBALL Owner 801-855-6368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine | |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2022-06-12 |