IndividualActive
Matthew Kanenwisher, RN
NPI 1104232834 · General Practice Registered Nurse · American Fork, UT
Provider details
- NPI number
- 1104232834
- Entity type
- Individual
- Primary specialty
- General Practice Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Male
- Sole proprietor
- No
- License
- 8274851-3102 (UT)
Mailing address
464 N 680 W
American Fork, UT 84003-3103
Registry dates
- Enumerated
- 2014-07-02
- Last updated
- 2020-02-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.