| Doctor Name: | KRISTIE K MARBUT |
| NPI Number: | 1225021934 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 50963944405 |
| Business Practice Address: | 4113 Bridgeport Way W Suite F University Place, WA - 984664325 |
| Business Phone Number: | 2535657686 |
| Business Fax Number: | 2535660210 |
| Mailing Address: | 3698 Redmaple Rd, SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841061521 |
| Phone Number: | 8019060513 |
| Fax Number: | 8019060516 |
| NPI Enumeration Date: | 08/26/2005 |
| NPI Last Update Date: | 09/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LN0005X |
| License Number: | 50963944405 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Neonatal, Critical Care |
| Taxonomy Definition: | |