Individual provider · Type 1 NPI
Kimber Tracy Van Wagoner, B.A., R.N.
Adult Psychiatric/Mental Health Registered Nurse · Salt Lake City, UT
NPI number
1801866512
Active
Practice location
1020 S Main St
Salt Lake City, UT 84101-3176
Fax (801) 539-7050
Mailing address
1134 E 2700 S, D 26
Salt Lake City, UT 84106-2642
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Psychiatric/Mental Health Registered Nurse Primary | 163WP0809X | 03081433102 (UT) |
Adult Psychiatric/Mental Health Registered Nurse: Definition to come...
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- Linda Marie Denton, RNAdult Psychiatric/Mental Health Registered Nurse Salt Lake City, UT NPI 1497726244
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About NPI 1801866512
Kimber Tracy Van Wagoner, B.A., R.N.'s National Provider Identifier is 1801866512, issued on Jan 25, 2006. The primary taxonomy on file is Adult Psychiatric/Mental Health Registered Nurse (163WP0809X), and the practice location is in Salt Lake City, UT. The record was last updated on Jul 13, 2026.