Individual
KATHLEEN R PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
22 S. STATE ST, CLEARFIELD, UT 84015
(801) 525-5158
(801) 525-5071
Mailing address
50 E. STATE ST, FARMINGTON, UT 84025
(801) 525-5158
(801) 525-5071
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4804114-3102
UT
Other
Enumeration date
12/30/2015
Last updated
12/30/2015
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