Individual
KATHRYN LUCILLE FENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1470 N MAIN ST STE A, BOUNTIFUL, UT 84010-5996
(801) 294-6747
Mailing address
PO BOX 816, CENTERVILLE, UT 84014-0816
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
4982179-3102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4982179-3102
RN
UT
Enumeration date
12/21/2006
Last updated
07/08/2007
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