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Individual

JANUARY KINGSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4019 W 12600 S, RIVERTON, UT 84096-7401
(801) 904-2488
Mailing address
4019 W 12600 S, RIVERTON, UT 84096-7401
(801) 904-2488

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12097073-4405
UT

Other

Enumeration date
01/05/2026
Last updated
01/05/2026
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