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1962961136
KRISTINE WISDOM
PROVO, UT
NPI
1962961136
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: UT 2654843102)
Enumeration Date
2019-03-18
Last Update Date
2019-03-18
Business Address
KRISTINE WISDOM RN
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
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Mailing Address
KRISTINE WISDOM RN
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-4760
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