Healthcare Provider Details

I. General information

NPI: 1083396980
Provider Name (Legal Business Name): KATHERINE MARIE ALLEMEIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 E EXCHANGE PL
SALT LAKE CITY UT
84111-2713
US

IV. Provider business mailing address

66 E EXCHANGE PL
SALT LAKE CITY UT
84111-2713
US

V. Phone/Fax

Practice location:
  • Phone: 801-895-4927
  • Fax:
Mailing address:
  • Phone: 801-895-4927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number11757055-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: