Provider Demographics
NPI:1710793153
Name:PAPEZ, KAYLA GOLDIE (APRN)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:GOLDIE
Last Name:PAPEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 E 4430 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CTY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-3776
Mailing Address - Country:US
Mailing Address - Phone:801-979-4234
Mailing Address - Fax:
Practice Address - Street 1:7138 S HIGHLAND DR STE 210
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84121-3782
Practice Address - Country:US
Practice Address - Phone:801-979-4234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8874399-4405207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine