Healthcare Provider Details

I. General information

NPI: 1538086988
Provider Name (Legal Business Name): GOLDEN POPPY WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

588 E MAIN ST STE C
LEHI UT
84043-2246
US

IV. Provider business mailing address

1440 E 140 S
PLEASANT GROVE UT
84062-3048
US

V. Phone/Fax

Practice location:
  • Phone: 801-855-6420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. KILEY MCCALL KIDD
Title or Position: CO-OWNER
Credential: LCSW
Phone: 801-855-6420