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General NPI Number Information
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NPI Number | 1457215519
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Entity Type | Organization
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Legal Business Name | ELESSAR PSYCHIATRY PLLC
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 169 W 2710 SOUTH CIR STE 202A
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City | ST GEORGE
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State | UT
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Zip | 84790-7205
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Country | US
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Telephone | 720-664-9877
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Fax | 888-350-9528
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Provider Business Mailing Address
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Address Line | 169 W 2710 SOUTH CIR STE 202A
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City | ST GEORGE
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State | UT
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Zip | 84790-7205
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Country | US
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Telephone | 720-664-9877
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Fax | 888-350-9528
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | KATY ALDERMAN
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Credential | MSN, PMHNP-BC
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Telephone | 720-664-9877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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