Provider Demographics
NPI:1447951462
Name:NORDFELT, KATELYN
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:NORDFELT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:BETH
Other - Last Name:MEADOWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2991 S GRAHAM PEAK DR
Mailing Address - Street 2:
Mailing Address - City:MAGNA
Mailing Address - State:UT
Mailing Address - Zip Code:84044-1795
Mailing Address - Country:US
Mailing Address - Phone:801-410-3921
Mailing Address - Fax:
Practice Address - Street 1:880 HERITAGE PARK BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5674
Practice Address - Country:US
Practice Address - Phone:801-327-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker