| Doctor Name: | KIMBERLY ANN GREAVES |
| NPI Number: | 1285818898 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 4732817-4405 |
| Business Practice Address: | 1915 W 5950 S Roy, UT - 840671454 |
| Business Phone Number: | 8013878100 |
| Business Fax Number: | 8013878248 |
| Mailing Address: | Po Box 27128, SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841270128 |
| Phone Number: | 8017796200 |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2007 |
| NPI Last Update Date: | 07/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 4732817-4405 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |