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General NPI Number Information
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NPI Number | 1801174164
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Entity Type | Individual
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Provider Name | SHARILYN SUE KIMBALL NP
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Gender | Female
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Dates
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Enumeration Date | 08/03/2011
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 2901 W BLUE GRASS BLVD STE 200
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City | LEHI
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State | UT
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Zip | 84043-4190
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Country | US
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Telephone | 801-368-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 7721 S UNION PARK AVE APT A409
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City | MIDVALE
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State | UT
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Zip | 84047-3023
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Country | US
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Telephone | 801-368-2160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 281140-4405
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License Number State | UT
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