Provider Demographics
NPI:1376112888
Name:TSUHAKO, KALI CONDIE (WHNP, CNM)
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:CONDIE
Last Name:TSUHAKO
Suffix:
Gender:F
Credentials:WHNP, CNM
Other - Prefix:
Other - First Name:KALI
Other - Middle Name:
Other - Last Name:CONDIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:585 N 500 W
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-1548
Mailing Address - Country:US
Mailing Address - Phone:385-985-5357
Mailing Address - Fax:801-216-8357
Practice Address - Street 1:3000 N TRIUMPH BLVD STE 210
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-7187
Practice Address - Country:US
Practice Address - Phone:801-756-1577
Practice Address - Fax:801-216-8357
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11311452-3102163W00000X
UT11311452363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health