MEDICARE: KAYLEE CHRISTENSEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		UT

General Provider Information

NPI Number	:	1346103975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEE CHRISTENSEN

Provider Business Mailing Address
First Line	:	1708 W 1160 S
Second Line	:
City	:	PAYSON
State	:	UT
Zip	:	84651-3206
Country	:	US
Telephone Number	:	385-535-3034
Fax Number	:	385-535-3034

Provider Business Practice Location Address
First Line	:	36 S STATE ST
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84111-1401
Country	:	US
Telephone Number	:	801-442-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “ KAYLEE CHRISTENSEN ” Practice Location

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