Provider Demographics
NPI:1205514817
Name:MERRILL, KRISTI (RN)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:MERRILL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 W ASPEN HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84045-6614
Mailing Address - Country:US
Mailing Address - Phone:801-427-9367
Mailing Address - Fax:
Practice Address - Street 1:40 N 200 W
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-1714
Practice Address - Country:US
Practice Address - Phone:385-374-1975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5120449-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse