NPI 1124096417

Raeanna Kirk, RN

Practitioner Child & Adolescent Psychiatric/Mental Health Registered Nurse Draper, UT

Practice location

Address: 11706 S 700 E, Draper, UT 84020-9365
Phone: (801) 963-4200

Registered specialties

Child & Adolescent Psychiatric/Mental Health Registered Nurse Primary

Nursing Service Providers Taxonomy 163WP0807X Licence 3082894-3102 (UT)

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Registry record

NPI: 1124096417
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Mar 2006
Record last updated: 8 Jun 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.