Kamille Boston Crockett, FNP
Individual provider Active NPI Ambulatory Women's Health Care Registered Nurse · Washington, UT
NPI 1336799956 · NPPES record last updated Sep 16, 2019
Key facts
- NPI
- 1336799956
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Ambulatory Women's Health Care Registered Nurse 163WW0101X
- License
- 8059814-3102 (UT)
- Practice address
- 757 W Telegraph St Ste 125
Washington, UT 84780-1533 - Phone
- (702) 994-0598
- NPI assigned
- Sep 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8059814-3102 | UT | MD | Ambulatory Women's Health Care Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Women's Health Care Registered Nurse | 163WW0101X | 8059814-3102 | UT | Yes |
Addresses
Primary practice location
757 W Telegraph St Ste 125
Washington, UT 84780-1533
Mailing address
1731 W Bridge Pointe Way
St George, UT 84770-5040
Phone (702) 994-0598
Other practice location 1
4245 S Grand Canyon Dr Ste 100
Las Vegas, NV 89147-7164
Phone (702) 994-0598
Other providers in Washington, UT
- De'Dy Chivers
- Nicole Choules
- Nathalie A Colin
- Monica C. Cook
- David Hales Coombs
- Clint Ctibor
- Emma Davis
- Lorna Davis
- Felicia Ann Day
- Paul Day
All providers in Washington, UT · Ambulatory Women's Health Care Registered Nurse in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.