Jansen, Kevin L
Jansen, Kevin L is an individual health care provider with primary practice located at 3702 S State St Ste 107 , South Salt Lake UT 84115-5096. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Jansen, Kevin L can be contacted via phone (801) 288-2634.Contact Information
Primary practice address
3702 S State St Ste 107
South Salt Lake UT 84115-5096
Phone: (801) 288-2634
Fax: (801) 288-1186
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 6555293-1205 | Utah |
Profile Details
NPI number | 1013908995 |
---|---|
LBN Legal business name | Jansen, Kevin L |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 31st, 2005 |
Last updated | May 2nd, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1013908995 | NPPES |
Utah | MEDICAID | 4828000340001 |
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