Provider Demographics
NPI:1528609880
Name:PULSIPHER, KYLEE (APRN)
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:PULSIPHER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 E RIPARIAN DR
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8544
Mailing Address - Country:US
Mailing Address - Phone:801-916-3580
Mailing Address - Fax:
Practice Address - Street 1:348 E 4500 S # 222
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-3906
Practice Address - Country:US
Practice Address - Phone:801-577-7055
Practice Address - Fax:888-717-7578
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8685977-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner