Provider Demographics
NPI:1932318805
Name:ROSSER, KRISTIE B (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:B
Last Name:ROSSER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:MRS
Other - First Name:KRISTIE
Other - Middle Name:B
Other - Last Name:ROSSER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:338 W 2600 N
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-9411
Mailing Address - Country:US
Mailing Address - Phone:801-899-6131
Mailing Address - Fax:801-705-0171
Practice Address - Street 1:338 W 2600 N
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-9411
Practice Address - Country:US
Practice Address - Phone:801-899-6131
Practice Address - Fax:801-705-0171
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT264698-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily