Individual
KRISTIN MAE SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
654 S 900 E, SALT LAKE CITY, UT 84102-3478
(801) 532-1586
Mailing address
654 S 900 E, SALT LAKE CITY, UT 84102-3478
(801) 532-1586
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8568206-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
297449
OMAP
OR
Enumeration date
11/28/2006
Last updated
11/04/2013
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