Individual
KIMBERLY K HISSONG
Active
Individual
KIMBERLY K HISSONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
185262-1205
UT
207L00000X
Anesthesiology Physician
Primary
C139617
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002084559
FIRST HEALTH
UT
05
—
002966900
—
ID
01
—
09300
VALLEY CHILDRENS HEALTHCARE
CA
01
—
107005891101
IHC
UT
05
—
111000400
—
WY
01
—
2000040
UNITED HEALTHCARE
UT
01
—
2403
HEALTHY U
UT
01
—
36403
PEHP
UT
05
—
401765
—
MT
01
—
416939
DESERET MUTUAL
UT
01
—
870280408HI1
EDUCATORS MUTUAL
UT
01
—
PR00880
MOLINA
UT
01
—
QM0000049524
ALTIUS
UT
Enumeration date
08/24/2006
Last updated
09/03/2020
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