Provider Demographics
NPI:1871058131
Name:MONEY, KYLIE ANN (PA-C)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:ANN
Last Name:MONEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5290 S 400 E
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-7194
Mailing Address - Country:US
Mailing Address - Phone:801-476-1777
Mailing Address - Fax:801-479-1479
Practice Address - Street 1:5290 S 400 E
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-7194
Practice Address - Country:US
Practice Address - Phone:801-476-1777
Practice Address - Fax:801-479-1479
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7757779-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant