Provider Demographics
NPI:1912788423
Name:KIFA HEALTH, LLC
Entity Type:Organization
Organization Name:KIFA HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/PMHNP
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINIKINI
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:801-618-7370
Mailing Address - Street 1:1984 W CANAL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84129-1498
Mailing Address - Country:US
Mailing Address - Phone:801-618-7370
Mailing Address - Fax:
Practice Address - Street 1:1984 W CANAL RIDGE RD
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84129-1498
Practice Address - Country:US
Practice Address - Phone:801-618-7370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty