Healthcare Provider Details

I. General information

NPI: 1972846806
Provider Name (Legal Business Name): KRISTINE ARMSTRONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 S COTTONWOOD ST
MURRAY UT
84107-5701
US

IV. Provider business mailing address

6521 S WESTBROOK DR
SALT LAKE CTY UT
84129-6140
US

V. Phone/Fax

Practice location:
  • Phone: 801-501-2685
  • Fax:
Mailing address:
  • Phone: 801-891-8481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number5166185-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: