Provider Demographics
NPI:1518400720
Name:HINDERMAN, KURTIS (NP-C)
Entity Type:Individual
Prefix:
First Name:KURTIS
Middle Name:
Last Name:HINDERMAN
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5226 FRONTIER DR
Mailing Address - Street 2:STE 500
Mailing Address - City:MORGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84050-9734
Mailing Address - Country:US
Mailing Address - Phone:801-268-4999
Mailing Address - Fax:801-261-3339
Practice Address - Street 1:5226 FRONTIER DR STE 500
Practice Address - Street 2:
Practice Address - City:MORGAN
Practice Address - State:UT
Practice Address - Zip Code:84050-9734
Practice Address - Country:US
Practice Address - Phone:801-268-4999
Practice Address - Fax:801-261-3339
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6439207-4405363LF0000X
UT6349207-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily