Healthcare Provider Details

I. General information

NPI: 1720881758
Provider Name (Legal Business Name): NATHELE KIANA KA'AIOHELO KAL LESA BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2172 E 7200 S
SPANISH FORK UT
84660-9340
US

IV. Provider business mailing address

550 MING AVE STE 410
BAKERSFIELD CA
93307
US

V. Phone/Fax

Practice location:
  • Phone: 801-423-5285
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number4961378-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: