Organization
MIDVALE FAMILY HEALTH CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ANN SPANGRUDE FNP-APRN (FAMILY NURSE PRACTITIONER)
(801) 561-2211
Entity
Organization
Contact information
Practice address
7852 PIONEER ST, MIDVALE, UT 84047-7415
(801) 561-2211
(801) 561-1076
Mailing address
7852 PIONEER ST, MIDVALE, UT 84047-7415
(801) 561-2211
(801) 561-1076
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
223145-4405,
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
571963692001
—
UT
Enumeration date
05/28/2006
Last updated
03/16/2010
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