Individual
MCKENNA STAPLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(615) 557-7022
Mailing address
658 E WILSON AVE, SALT LAKE CITY, UT 84105-3008
(615) 557-7022
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10406372-4405
UT
363LS0200X
School Nurse Practitioner
10406372-3102
UT
Other
Enumeration date
06/08/2021
Last updated
12/12/2022
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