Individual
KIMBERLY MORTENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
48 N 1100 E, SUITE C, AMERICAN FORK, UT 84003-2910
(801) 492-4933
(801) 492-4371
Mailing address
48 N 1100 E, SUITE C, AMERICAN FORK, UT 84003-2910
(801) 492-4933
(801) 492-4371
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
2756754405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00300688
PALMETTO
UT
Enumeration date
09/27/2006
Last updated
12/12/2011
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