Provider Demographics
NPI:1255061719
Name:CHAPMAN, KYLIE (DNP)
Entity type:Individual
Prefix:DR
First Name:KYLIE
Middle Name:
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:UT
Mailing Address - Zip Code:84312-9764
Mailing Address - Country:US
Mailing Address - Phone:801-603-6576
Mailing Address - Fax:
Practice Address - Street 1:905 N 1000 W
Practice Address - Street 2:
Practice Address - City:TREMONTON
Practice Address - State:UT
Practice Address - Zip Code:84337-9356
Practice Address - Country:US
Practice Address - Phone:435-207-4512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT97981333102163W00000X
UT9798133-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse