Provider Demographics
NPI:1316673007
Name:MURPHY, KELSI NICHOLE (PA-C)
Entity type:Individual
Prefix:
First Name:KELSI
Middle Name:NICHOLE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5292 S COLLEGE DR STE 202
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-2960
Mailing Address - Country:US
Mailing Address - Phone:801-590-4508
Mailing Address - Fax:
Practice Address - Street 1:5292 S COLLEGE DR STE 202
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84123-2960
Practice Address - Country:US
Practice Address - Phone:801-590-4508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2024-08-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant