Healthcare Provider Details

I. General information

NPI: 1285541888
Provider Name (Legal Business Name): KYLEIGH YERGENSEN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

792 S 3000 E STE 104
ST GEORGE UT
84790-1801
US

IV. Provider business mailing address

1173 S 250 W STE 301
ST GEORGE UT
84770-6753
US

V. Phone/Fax

Practice location:
  • Phone: 801-883-8203
  • Fax:
Mailing address:
  • Phone: 435-986-9369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number11283909-2402
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: