Healthcare Provider Details

I. General information

NPI: 1730543620
Provider Name (Legal Business Name): KATY ALDERMAN PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATY STICKLE

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5373 S GREEN ST STE 400
MURRAY UT
84123-4740
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 833-442-2670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number8367118-3102
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number8367118-4405
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number8367118-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: