MR. KIRK RUSSELL WALDRON (NPI# 1215599105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215599105 |
| Entity Type | Individual |
| Full Name | MR. KIRK RUSSELL WALDRON |
| Credential | FNP-C |
| Practice Address |
770 S 200 E Ste 102 Brigham City UT 84302-3387 |
| Practice Telephone | 8015139652 |
| Mailing Telephone | 8015139652 |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2019-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
7301549-8900 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
770 S 200 E STE 102 |
| City | BRIGHAM CITY |
| State | UT |
| Zip Code | 84302-3387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669945531 | Brandon Lee Allen | Counselor | 971 South 800 West, #104, Brigham City, UT 84302 | 2019-01-03 |
| 1104307495 | Tiffany Burnhope | Social Worker | 663 Parker Lane, Brigham City, UT 84302 | 2018-08-24 |
| 1558858464 | Michael Clark | Optometrist | 990 Medical Dr Ste G3, Brigham City, UT 84302 | 2018-04-16 |
| 1497273130 | Emily Marler | Counselor | 862 South Main Suite 4, Brigham City, UT 84302 | 2017-09-01 |
| 1003268731 | Tyler Beckstrand | Social Worker | 125 N Main Street, Brigham City, UT 84302 | 2016-07-06 |
| 1780030155 | Angela Stott | Case Manager/Care Coordinator | 160 E 800 S Apt. B216, Brigham City, UT 84302 | 2016-05-04 |
| 1699156802 | Christopher Jacobson | Family Medicine | 1050 Medical Dr, Brigham City, UT 84302 | 2015-06-12 |
| 1811377765 | Courtney Allred | Counselor | 863 S Main Street Suite 2, Brigham, UT 84302 | 2015-06-05 |
| 1235529579 | Belinda Castro | Counselor | 862 S Main Street Suite 2, Brigham City, UT 84302 | 2015-01-26 |
| 1760871818 | Ambryn Mccallson | Counselor | 862 S. Main, 4, Brigham City, UT 84302 | 2015-01-13 |
| Find all providers in zip 84302 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437147576 | Julie C. Child | Nurse Practitioner | 1050 South Medical Drive, Ste 101, Brigham City, UT 84302 | 2005-10-12 |
| 1063020949 | Justin Michael Woodruff | Nurse Practitioner | 663 Parker Lane, Brigham City, UT 84302 | 2020-07-16 |
| 1588297360 | Carla Knighton Smith | Nurse Practitioner | 600 W Hospital Rd, Brigham City, UT 84302-3006 | 2020-02-19 |
| 1851894752 | Rachel Zorko Burris | Nurse Practitioner | 984 Medical Dr Ste 1, Brigham City, UT 84302-4712 | 2018-03-16 |
| 1629508403 | Kelsey Bywater | Nurse Practitioner | 984 Medical Dr Ste 1, Brigham City, UT 84302-4712 | 2017-06-14 |
| 1992154777 | Kellie Nielsen | Nurse Practitioner | 600 W Hospital Rd, Brigham City, UT 84302-3006 | 2016-06-13 |
| 1194038489 | Lindee P Allen | Nurse Practitioner | 600 W Hospital Rd, Brigham City, UT 84302-3006 | 2010-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204590 | Gabrielle Sleater Lewis | Nurse Practitioner | 2905 S Mcclelland St, Salt Lake City, UT 84106-2125 | 2020-11-01 |
| 1164021721 | Mistie Sue Manning | Nurse Practitioner | 1551 Renaissance Towne Dr Ste 370, Bountiful, UT 84010-7675 | 2020-10-23 |
| 1023617404 | Michaelle Lei Spears | Nurse Practitioner | 922 W Baxter Dr, South Jordan, UT 84095-8613 | 2020-10-18 |
| 1649878935 | Kecia Kristine Chandler | Nurse Practitioner | 285 N Main St Unit 692, Kaysville, UT 84037-6027 | 2020-10-09 |
| 1386251742 | Jennifer Lynn Castillo | Nurse Practitioner | 280 S 9500 E, Huntsville, UT 84317-9766 | 2020-09-29 |
| 1174130629 | Jessica Noel Wagner | Nurse Practitioner | 12828 S 3600 W Ste 101, Riverton, UT 84065-6853 | 2020-09-29 |
| 1962019596 | Freya Kristen Landesman | Nurse Practitioner | 60 E South Temple Ste 300, Salt Lake City, UT 84111-1041 | 2020-09-28 |
| 1750998860 | Jeremy Llewellyn | Nurse Practitioner | 395 W Cougar Blvd Fl 5, Provo, UT 84604-3323 | 2020-09-24 |
| 1356957781 | Holly Lovell | Nurse Practitioner | 56 S 1030 E, Santaquin, UT 84655-5698 | 2020-09-21 |
| 1861005688 | Cara Susan Jones Ahlstrom | Nurse Practitioner | 81 N Havenwood Dr, Kaysville, UT 84037-6881 | 2020-08-31 |
| Find all providers with the same taxonomy | ||||
| City | BRIGHAM CITY |
| Zip Code | 84302 |
Please comment or provide details below to improve the information on MR. KIRK RUSSELL WALDRON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.