KIM MARIE MCKINNON NP NPI 1003302548

NPI Information

NPI: 1003302548
Provider Name: KIM MARIE MCKINNON, NP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Organization: ANDERSON WELLNESS GROUP LLC

PECOS Registration: Yes

Address:
45 W SEGO LILY DR STE 312
SANDY, UT
ZIP 84070
Phone: (801) 676-9452
Get Directions

Kim Marie Mckinnon, NP is a psychiatric/mental health nurse practitioner in Sandy, UT with 6 years of experience. Kim Marie Mckinnon, NP NPI is 1003302548. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

45 W SEGO LILY DR STE 312
SANDY, UT
ZIP 84070-643
Phone: (801) 676-9452
Fax: (801) 206-9734

The NPI 1003302548 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/9/2018 and was last updated on 1/13/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208100000X	Physical Medicine & Rehabilitation		294366-4405	UTAH	No
2	363LF0000X	Nurse Practitioner	Family	294366-8900	UTAH	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	294366-8900	UTAH	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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