Healthcare Provider Details

I. General information

NPI: 1093518359
Provider Name (Legal Business Name): KATHY ALEXANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2172 E 7200 S
SPANISH FORK UT
84660-9340
US

IV. Provider business mailing address

523 S DOUBLEDAY ST
MAPLETON UT
84664-4353
US

V. Phone/Fax

Practice location:
  • Phone: 801-423-5304
  • Fax:
Mailing address:
  • Phone: 925-337-6528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1069666-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: