Individual
MRS. KRISTINA MARIE RAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.N.P.
Contact information
Practice address
3723 W 12600 S, RIVERTON, UT 84065-7295
(801) 507-4384
(801) 507-4398
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
6611255-4405
UT
Other
Enumeration date
09/29/2014
Last updated
06/25/2024
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