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General NPI Number Information
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NPI Number | 1164888707
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Entity Type | Individual
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Provider Name | ALYSSA KAY KLINGBEIL AGNP-C, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 3903 MEDICAL DR STE 300
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City | OGDEN
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State | UT
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Zip | 84403-2317
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Country | US
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Telephone | 801-387-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 3903 MEDICAL DR STE 300
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City | OGDEN
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State | UT
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Zip | 84403-2317
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | C-APN.0000702-C-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 13430769-4405
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License Number State | UT
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