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General NPI Number Information
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NPI Number | 1609556596
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Entity Type | Individual
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Provider Name | MARY DANIELLE KUYKENDALL PMHNP, APRN
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Gender | Female
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 60 E 3750 S
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City | SOUTH SALT LAKE
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State | UT
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Zip | 84115-4428
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Country | US
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Telephone | 801-486-0911
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Fax | 801-262-3709
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Provider Business Mailing Address
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Address Line | PO BOX 850
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City | OAKLEY
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State | UT
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Zip | 84055-0801
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Country | US
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Telephone | 801-696-2444
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 77110
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License Number State | ID
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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 | 8658127-4405
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License Number State | UT
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