Individual
JOHN R KILLPACK
Active
Individual
JOHN R KILLPACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
201807-4406
UT
367500000X
Certified Registered Nurse Anesthetist
CR001222
SD
367500000X
Certified Registered Nurse Anesthetist
Primary
D193331
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100505357
FIRST HEALTH
UT
01
—
107026813102
IHC
UT
01
—
2000630
UNITED HEALTHCARE
UT
01
—
201060254KIL
EDUCATORS MUTUAL
UT
01
—
597854
HEALTHY U
UT
01
—
79799
PEHP
UT
01
—
851396
DESERET MUTUAL
UT
05
—
943284
—
AZ
01
—
TPRA09124
MOLINA
UT
Enumeration date
08/18/2006
Last updated
08/19/2026
Update your record
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