MEDICARE: KATHLEEN FILLNOW

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
1	104100000X	Social Worker	9429663-3501	UT

General Provider Information

NPI Number	:	1598149700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN FILLNOW

Provider Business Mailing Address
First Line	:	5965 S 900 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-1720
Country	:	US
Telephone Number	:	801-263-7138
Fax Number	:

Provider Business Practice Location Address
First Line	:	5965 S 900 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-1720
Country	:	US
Telephone Number	:	801-263-7138
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2015
Last Update Date	:	03/26/2026

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Directions to “ KATHLEEN FILLNOW ” Practice Location

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