Individual
NICOLE KENYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2634
Mailing address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0001
(801) 581-2634
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051292368
IL
183500000X
Pharmacist
Primary
7000540-1701
UT
Other
Enumeration date
06/18/2009
Last updated
06/18/2009
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