Individual
KIMBER KATHLEEN WATSON NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
395 W COUGAR BLVD STE 205, PROVO, UT 84604-3328
(801) 357-1770
(801) 357-1779
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10106906-1206
UT
363A00000X
Physician Assistant
PA20714
CA
Other
Enumeration date
12/02/2009
Last updated
06/25/2024
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