MS. KAYLEEN TERRY (NPI# 1992828958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992828958 |
| Entity Type | Individual |
| Full Name | MS. KAYLEEN TERRY |
| Credential | A.P.R.N. |
| Practice Address |
5323 Woodrow St Ste 102 Murray UT 84107-5841 |
| Practice Telephone | 8017131010 |
| Practice Fax Number | 8017130665 |
| Mailing Telephone | 8017131010 |
| Mailing Fax Number | 8017130665 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2010-04-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
150335-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
150335-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | MEDICARE SUBMITTER ID NUM | UT03672 | 01 |
| UT | GROUP PIN | 000057906 | 01 |
| Street Address |
5323 WOODROW ST STE 102 |
| City | MURRAY |
| State | UT |
| Zip Code | 84107-5841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023313020 | Breawn Rizzuto | Nurse Practitioner | 5323 Woodrow St, Suite #102, Murray, UT 84107-5841 | 2011-01-21 |
| 1447562764 | Christopher Davis | Physician Assistant | 5323 Woodrow St, Suite 200, Murray, UT 84107-5841 | 2010-07-02 |
| 1205083763 | Rachel Dresher Gurr | Physician Assistant | 5323 Woodrow St, Murray, UT 84107-5841 | 2008-08-26 |
| 1104910355 | Sleep Institute of Utah Lc | Clinic/Center | 5323 Woodrow St, Ste 205, Murray, UT 84107-5841 | 2006-10-03 |
| 1346260247 | Evan G Black | Psychiatry & Neurology | 5323 Woodrow St, #201, Murray, UT 84107-5841 | 2006-07-20 |
| 1174543060 | Diana D. Banks | Psychiatry & Neurology | 5323 Woodrow St, #201, Murray, UT 84107-5841 | 2006-07-20 |
| 1427005586 | Mmps Murray | Clinic/Center | 5323 Woodrow St, Murray, UT 84107-5841 | 2006-05-27 |
| 1730138629 | Maya Thomas | Psychiatry & Neurology | 5323 Woodrow St, Murray, UT 84107-5851 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609104553 | Denise Westover | Nurse Practitioner | 5169 S. Cottonwood St, Ste. 520, Murray, UT 84107 | 2009-12-03 |
| 1568457398 | Jennie Kaye Bourne | Nurse Practitioner | 300 S 8th St Ste 401e, Murray, KY 42071 | 2005-09-19 |
| 1568976579 | Andrew James Aloia | Nurse Practitioner | 5131 S Cottonwood St, Murray, UT 84107-5701 | 2017-11-29 |
| 1184148447 | Karyn Peirce | Nurse Practitioner | 5121 S Cottonwood St, Murray, UT 84107-5701 | 2017-07-28 |
| 1932513702 | Stephanie Nason | Nurse Practitioner | 1000 S 12th St, Murray, KY 42071-9303 | 2014-06-19 |
| 1700110103 | Kathleen Farrell | Nurse Practitioner | 1005 Poplar St, Murray, KY 42071-2436 | 2009-10-01 |
| 1356508857 | Kimberly Dawn Megwalu | Nurse Practitioner | 5250 S 320 W, Suite 305, Murray, UT 84107-7926 | 2008-05-21 |
| 1164698312 | Christopher Michael Poch | Nurse Practitioner | 5121 South Cottonwood Drive, Murray, UT 84157 | 2008-05-07 |
| 1801942255 | Virginia Grider | Nurse Practitioner | 310 N 4th St, Murray, KY 42071-2002 | 2007-01-26 |
| 1568538528 | Roberta Ann Lucas | Nurse Practitioner | 835 E 4800 S, Murray, UT 84107-5040 | 2006-11-28 |
| Find all providers in MURRAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.