Slack, Caryn Kendra

Slack, Caryn Kendra is an individual health care provider with primary practice located at 4535 S 5600 W , West Valley City UT 84120-4639. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Slack, Caryn Kendra can be contacted via phone (801) 676-4405.

Contact Information

Primary practice address
4535 S 5600 W West Valley City UT 84120-4639
Fax: (877) 497-4661
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5597655-1205 Utah

Profile Details

NPI number 1689619124
LBN Legal business name Slack, Caryn Kendra
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2006
Last updated Nov 18th, 2021 - about 3 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689619124 NPPES
Utah MEDICAID 1164672770

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