Provider Demographics
NPI:1689772741
Name:KLEINSCHMIT, KRISTI KAY (MD)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:KAY
Last Name:KLEINSCHMIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 S 1300 E
Mailing Address - Street 2:#2
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1793
Mailing Address - Country:US
Mailing Address - Phone:801-585-1212
Mailing Address - Fax:801-585-9096
Practice Address - Street 1:650 KOMAS DR
Practice Address - Street 2:#208
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1215
Practice Address - Country:US
Practice Address - Phone:801-585-1212
Practice Address - Fax:801-585-9096
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT540058512052084N0400X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology