NPI 1013312339

Nicole Kelly, PAC

Practitioner Physician Assistant Draper, UT

Practice location

Address: 12340 S 450 E, Draper, UT 84020-8154
Phone: (801) 501-9797
Mailing address: 8899 S 700 E Suite 250, Sandy, UT 84070-1810

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 9190865-1206 (UT)

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Registry record

NPI: 1013312339
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Oct 2014
Record last updated: 1 Aug 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.