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Individual

KRISTIN VAN TASSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
118 N MAIN ST, SUITE B, SALEM, UT 84653-5698
(801) 477-9007
Mailing address
118 N MAIN ST, SUITE B, SALEM, UT 84653-5698
(801) 477-9007

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6097293-4405
UT

Other

Enumeration date
01/18/2015
Last updated
01/18/2015
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