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Individual
KIM MARIE MCKINNON
Active
Individual
KIM MARIE MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
294366-4405
UT
363LF0000X
Family Nurse Practitioner
294366-8900
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
294366-8900
UT
Other
Enumeration date
07/09/2018
Last updated
01/13/2021
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