Individual
KAMILLE THAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12391 S 4000 W, RIVERTON, UT 84096-7012
(801) 302-1750
Mailing address
2965 W 3500 S, WEST VALLEY CITY, UT 84119-3602
(801) 965-3600
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
9421907-3102
UT
363L00000X
Nurse Practitioner
Primary
9421907-4405
UT
Other
Enumeration date
05/17/2024
Last updated
08/06/2026
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