Provider Demographics
NPI:1659923597
Name:PEARSON, KAYCE (DEM)
Entity Type:Individual
Prefix:
First Name:KAYCE
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 N 625 W APT 2
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-8715
Mailing Address - Country:US
Mailing Address - Phone:435-851-9526
Mailing Address - Fax:
Practice Address - Street 1:1332 N 625 W APT 2
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-8715
Practice Address - Country:US
Practice Address - Phone:435-851-9526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay