Doctor Name: | BARI MICHELLE KING |
NPI Number: | 1063445948 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | F.N.P. |
License Number: | 197485-4405 |
Business Practice Address: | 3570 W 9000 S Suite, 100 West Jordan, UT - 840888869 |
Business Phone Number: | 8015691999 |
Business Fax Number: | 8015692001 |
Mailing Address: | 3570 W 9000 S, Suite, 100 WEST JORDAN |
State: | UT |
Postal Code: | 840888869 |
Phone Number: | 8015691999 |
Fax Number: | 8015692001 |
NPI Enumeration Date: | 07/07/2006 |
NPI Last Update Date: | 04/22/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 197485-4405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |