Individual
KIMBERLY HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
180 S 300 E, MOAB, UT 84532-2620
(435) 260-9864
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
10882600-3102
UT
390200000X
Student in an Organized Health Care Education/Training Program
10882600-3102
UT
Other
Enumeration date
12/13/2024
Last updated
04/10/2025
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