Provider Demographics
NPI:1720273329
Name:MUESKE, KEVIN B (RN)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:B
Last Name:MUESKE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13237 S 2480 W
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84065-2265
Mailing Address - Country:US
Mailing Address - Phone:801-878-9617
Mailing Address - Fax:
Practice Address - Street 1:2525 LAKE PARK BLVD
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-8230
Practice Address - Country:US
Practice Address - Phone:801-982-3071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6647611-3102163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health