CAITLIN BROOK MALLORY (NPI# 1124509070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124509070 |
| Entity Type | Individual |
| Full Name | CAITLIN BROOK MALLORY |
| Credential | FNP |
| Practice Address |
1055 N 500 W Bldg A Provo UT 84604-3305 |
| Mailing Address |
1055 N 500 W Attn. Credentialing Provo UT 84604 |
| Practice Telephone | 8018125033 |
| Practice Fax Number | 8018125034 |
| Mailing Telephone | 8013548225 |
| Mailing Fax Number | 8014180941 |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2020-02-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
7725435-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1055 N 500 W BLDG A |
| City | PROVO |
| State | UT |
| Zip Code | 84604-3305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396741476 | Kipp Moreno Robins | Otolaryngology | 1055 N 500 W Bldg A, Provo, UT 84604-3305 | 2005-06-23 |
| 1184221095 | Aubree Mckell Earnest | Nurse Practitioner | 1055 N 500 W Bldg A, Provo, UT 84604-3305 | 2020-10-04 |
| 1700404274 | Riley Wayne Petersen | Nurse Practitioner | 1055 N 500 W Bldg A, Provo, UT 84604-3305 | 2020-07-10 |
| 1194290551 | Leah Toshina Young | Physician Assistant | 1055 N 500 W Bldg A, Provo, UT 84604 | 2018-10-11 |
| 1235614959 | Mark W Sears | Physician Assistant | 1055 N 500 W Bldg A, Provo, UT 84604-3305 | 2018-09-27 |
| 1851802490 | Megan M. Kennedy | Dietitian, Registered | 1055 N 500 W Bldg A, Provo, UT 84604-3305 | 2017-10-23 |
| 1477085090 | Natalie Lois Jensen | Registered Nurse | 1055 N 500 W Bldg A, Provo, UT 84604-3305 | 2017-04-02 |
| 1134662729 | Jason Allen | Physician Assistant | 1055 N 500 W Bldg A, Provo, UT 84604-3305 | 2016-11-30 |
| 1295140911 | Adriana Martinez | Nurse Practitioner | 1055 N 500 W Bldg A, Provo, UT 84604-3305 | 2014-06-23 |
| 1437585155 | Michael Scott Robinson | Nurse Practitioner | 1055 N 500 W Bldg A, Provo, UT 84604-3305 | 2013-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750998860 | Jeremy Llewellyn | Nurse Practitioner | 395 W Cougar Blvd Fl 5, Provo, UT 84604-3323 | 2020-09-24 |
| 1336765882 | Julie Andrea Rogers | Nurse Practitioner | 428 W 4620 N, Provo, UT 84604-5537 | 2020-06-21 |
| 1992337208 | Xiao Xiao Zou Hoffman | Nurse Practitioner | 1747 N 1500 W, Provo, UT 84604-1146 | 2020-02-05 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1174095855 | Jared Hawkins | Nurse Practitioner | 1034 N 500 W # 84604, Provo, UT 84604-3380 | 2018-12-19 |
| 1891270062 | Catherine Leilani Barrus | Nurse Practitioner | 2833 Indian Hills Cir, Provo, UT 84604-4333 | 2018-10-03 |
| 1760968804 | Amanda Graves | Nurse Practitioner | 1900 N State St Ste 103, Provo, UT 84604-1354 | 2018-07-12 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1205356250 | Gordon Dale Mills Jr. | Nurse Practitioner | 1055 N 500 W # 212, Provo, UT 84604-3305 | 2017-06-21 |
| 1770034845 | Megan Mackenzie Zitting | Nurse Practitioner | 1437 E 1270 S, Provo, UT 84606-6527 | 2016-10-24 |
| Find all providers in PROVO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.