Healthcare Provider Details

I. General information

NPI: 1225958713
Provider Name (Legal Business Name): KAITLYN GELB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7302 S BINGHAM JUNCTION BLVD
MIDVALE UT
84047-4804
US

IV. Provider business mailing address

1367 E MILLER AVE UNIT A602
MILLCREEK UT
84106-4955
US

V. Phone/Fax

Practice location:
  • Phone: 585-880-5411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number30572
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: