Individual
MRS. RAEANNA KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11706 S 700 E, DRAPER, UT 84020-9365
(801) 963-4200
Mailing address
11706 S 700 E, DRAPER, UT 84020-9365
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
3082894-3102
UT
Other
Enumeration date
03/10/2006
Last updated
06/08/2010
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