Healthcare Provider Details

I. General information

NPI: 1275250235
Provider Name (Legal Business Name): KELSIE FAITH REECE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1076 N 2000 W ST SUITE 500
PLEASANT GROVE UT
84062
US

IV. Provider business mailing address

1076 N 2000 W ST SUITE 500
PLEASANT GROVE UT
84062
US

V. Phone/Fax

Practice location:
  • Phone: 385-985-8076
  • Fax: 801-980-7791
Mailing address:
  • Phone: 385-985-8076
  • Fax: 801-980-7791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10496724-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: