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NPI Code Detail

MEDICARE: KATELYN NORDFELT

MEDICARE: KATELYN NORDFELT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1447951462
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN NORDFELT
Provider Business Mailing Address
First Line : 2991 S GRAHAM PEAK DR
Second Line :
City : MAGNA
State : UT
Zip : 84044-1795
Country : US
Telephone Number : 801-410-3921
Fax Number :
Provider Business Practice Location Address
First Line : 880 HERITAGE PARK BLVD STE 130
Second Line :
City : LAYTON
State : UT
Zip : 84041-5674
Country : US
Telephone Number : 801-327-2266
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2023
Last Update Date : 12/31/2024

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Directions to “ KATELYN NORDFELT ” Practice Location

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