Individual
KIMBERLY GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
2550 S MAIN ST APT 6203, SOUTH SALT LAKE, UT 84115-3083
(708) 278-5602
Mailing address
2550 S MAIN ST APT 6203, SOUTH SALT LAKE, UT 84115-3083
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
10152046-3102
UT
Other
Enumeration date
12/16/2021
Last updated
12/16/2021
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