Healthcare Provider Details

I. General information

NPI: 1730083031
Provider Name (Legal Business Name): ESTELLA KEELE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2183 W MAIN ST STE A107
LEHI UT
84043-6761
US

IV. Provider business mailing address

898 S 160 W
AMERICAN FORK UT
84003-4257
US

V. Phone/Fax

Practice location:
  • Phone: 385-203-1215
  • Fax: 801-655-5217
Mailing address:
  • Phone: 801-372-7580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8263799-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: