Provider Demographics
NPI:1477167245
Name:NUNEVILLER, KRISTIE
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:NUNEVILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 ACADIANA LN
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:TX
Mailing Address - Zip Code:77586-8309
Mailing Address - Country:US
Mailing Address - Phone:801-473-3963
Mailing Address - Fax:801-797-1220
Practice Address - Street 1:855 E 4800 S STE 100
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5513
Practice Address - Country:US
Practice Address - Phone:801-473-3963
Practice Address - Fax:801-797-1220
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No172V00000XOther Service ProvidersCommunity Health Worker