Basic Information
| Provider Information | |||||||||
| NPI: | 1689772741 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KLEINSCHMIT | ||||||||
| FirstName: | KRISTI | ||||||||
| MiddleName: | KAY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32 S 1300 E | ||||||||
| Address2: | #2 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841021793 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015851212 | ||||||||
| FaxNumber: | 8015859096 | ||||||||
| Practice Location | |||||||||
| Address1: | 650 KOMAS DR | ||||||||
| Address2: | #208 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 841081215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8015851212 | ||||||||
| FaxNumber: | 8015859096 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 12/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 54005851205 | UT | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 208000000X | 54005851205 | UT | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.