Healthcare Provider Details

I. General information

NPI: 1164337754
Provider Name (Legal Business Name): KAYLI HARRIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 E MEDICAL CENTER DR STE 2100
ST GEORGE UT
84790-2129
US

IV. Provider business mailing address

2520 BLACKHAWK DR UNIT 82
SANTA CLARA UT
84765-1239
US

V. Phone/Fax

Practice location:
  • Phone: 435-251-3250
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number136893573102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: