Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | 221071-4405 | UT |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 221071-4405 | UT |
NPI | 1134127640 |
---|---|
Provider Name | Kari Wood |
First Address | Lehi, UT 84043-4587 |
Second Address | Orem, UT 84057-3660 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9639329 | (05) | WA |