Provider Demographics
NPI:1801524426
Name:CALDWELL, KAYLA RHENEA (LPN)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:RHENEA
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 S 900 W APT 303
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-2384
Mailing Address - Country:US
Mailing Address - Phone:662-891-8076
Mailing Address - Fax:
Practice Address - Street 1:9361 S 300 E
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-2902
Practice Address - Country:US
Practice Address - Phone:801-826-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12879772-3101164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse