Individual
MRS. KIMBERLY A SPANGRUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3354 E RUTLAND PL, COTTONWOOD HEIGHTS, UT 84121-5829
(801) 971-1739
Mailing address
2233 E. MAIN ST., BUSINESS OPTIONS MEDICAL BILLING, MONTROSE, CO 81401-3831
(970) 765-0810
(970) 497-8410
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
223145-4405
UT
363LF0000X
Family Nurse Practitioner
C-APN.0991964-C-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
451870YS6E
MEDICARE PART B FOR LBN: OLATHE COMMUNITY CLINIC
CO
Enumeration date
03/15/2006
Last updated
10/12/2018
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