Healthcare Provider Details

I. General information

NPI: 1184148447
Provider Name (Legal Business Name): KARYN PEIRCE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 07/28/2017
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

374 E 1500 S
KAYSVILLE UT
84037-4055
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-4000
  • Fax:
Mailing address:
  • Phone: 801-529-2197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4936209-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: