Individual
KIRSTEN E BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1407 N 2000 W, CLINTON, UT 84015-8562
(385) 333-7123
Mailing address
1407 N 2000 W, CLINTON, UT 84015-8562
(385) 333-7123
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
16501
NH
207LP2900X
Pain Medicine (Anesthesiology) Physician
16501
NH
208VP0014X
Interventional Pain Medicine Physician
16501
NH
208VP0014X
Interventional Pain Medicine Physician
Primary
9777824-1205
UT
Other
Enumeration date
05/31/2008
Last updated
01/28/2021
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