Provider Demographics
NPI:1104208115
Name:HORSLEY, KENZY KAYE
Entity Type:Individual
Prefix:MRS
First Name:KENZY
Middle Name:KAYE
Last Name:HORSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-2233
Mailing Address - Country:US
Mailing Address - Phone:801-735-5371
Mailing Address - Fax:
Practice Address - Street 1:25 E CENTER ST
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-2233
Practice Address - Country:US
Practice Address - Phone:801-735-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9426800-3101164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse