Krystal Booth

Individual provider Active NPI Community Health Worker · Orem, UT

NPI 1154934636 · NPPES record last updated Aug 25, 2020

Key facts

NPI
1154934636
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
581 W 1600 N
Orem, UT 84057-2571
Phone
(180) 147-3396
Fax
(801) 797-1220
NPI assigned
Aug 25, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Papilion Integrated Recovery Centers Current
since Aug 30, 2020
Accepting new patients

Locations

581 W 1600 N
Orem, UT 84057
Phone (801) 368-8423

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

581 W 1600 N
Orem, UT 84057-2571

Mailing address

2414 Acadiana LN
Seabrook, TX 77586-8309
Phone (180) 147-3396

Other providers in Orem, UT

All providers in Orem, UT · Community Health Worker in Utah

Sources for this page

Verify at the official NPI Registry.