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:
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Health care specialties

SpecialtyCodeLicense #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 2 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 1013908995 NPPES
Utah MEDICAID 4828000340001

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