Individual
KERIANN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2147 E BORG DR, SANDY, UT 84092-4115
(801) 651-2454
Mailing address
2147 E BORG DR, SANDY, UT 84092-4115
(801) 651-2454
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
8434532-3102
UT
Other
Enumeration date
04/29/2016
Last updated
04/29/2016
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