GRACE-MAE CACHERO GENITIANO KELLY (NPI# 1265916639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265916639 |
Entity Type | Individual |
Full Name | GRACE-MAE CACHERO GENITIANO KELLY |
Practice Address |
4460 S Highland Dr Slc UT 84124-3543 |
Practice Telephone | 8889494864 |
Enumeration Date | 2018-09-20 |
Last Update Date | 2019-11-12 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
6300561-4405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Street Address |
4460 S HIGHLAND DR |
City | SLC |
State | UT |
Zip Code | 84124-3543 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780156414 | Cara Hill | Community Health Worker | 4460 S Highland Dr, Slc, UT 84124-3543 | 2018-12-19 |
1891277521 | Cheryl Christy | Counselor | 4460 S Highland Dr, Slc, UT 84124-3543 | 2018-08-29 |
1356820872 | Travis Pentz Miller | Behavior Technician | 4460 S Highland Dr, Slc, UT 84124-3543 | 2018-08-07 |
1548765761 | Megan Argyle | Technician/Technologist | 4460 S Highland Dr, Slc, UT 84124-3543 | 2018-03-28 |
1225572167 | Briann Rachele Titcomb | Counselor | 4460 S Highland Dr, 230, Slc, UT 84124-3543 | 2016-12-12 |
1710420831 | John Allen | Counselor | 4460 S Highland Dr, 203, Slc, UT 84124-3543 | 2016-11-21 |
1255882023 | Olivia Hu | Counselor | 4460 S Highland Dr, Slc, UT 84124-3543 | 2016-10-17 |
1003364001 | Levi Ernest | Counselor | 4460 S Highland Dr, Suite 230, Slc, UT 84124-3543 | 2016-09-19 |
1770039836 | Georgina Bellazetin | Counselor | 4460 S Highland Dr, #230, Slc, UT 84124-3543 | 2016-08-29 |
1538522073 | Danielle Reasch | Counselor | 4460 S Highland Dr, Suite 230, Slc, UT 84124-3543 | 2016-04-01 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
Find all providers in zip 84124 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942860481 | Robin Morgan | Nurse Practitioner | Lds Hospital 8th Ave & C Street, Slc, UT 84143-0001 | 2019-06-17 |
1659520807 | Treasure Ashleigh Morgan | Nurse Practitioner | 1010 E 2100 S, Suite B, Slc, UT 84106-3590 | 2008-09-11 |
1952596827 | Alisa A Seeberger | Nurse Practitioner | 1548 E 4500 S Ste 202, Slc, UT 84117-5209 | 2007-09-12 |
1992922520 | Kathy Marie Parry | Nurse Practitioner | Slc Va, 500 Foothill Dr, Slc, UT 84148-0001 | 2007-04-18 |
1770631079 | Linda Young Lewis | Nurse Practitioner | 100 N Medical Dr Ste 3400, Slc, UT 84113-1103 | 2007-01-05 |
1356366181 | Julianne Fallentine | Nurse Practitioner | 855 California Ave, Slc, UT 84104-1632 | 2006-07-13 |
1770194979 | Kelli Dru Webster | Nurse Practitioner | 500 Foothill Dr, Slc, UT 84148-0001 | 2020-08-11 |
1952929895 | Caren D Erekson | Nurse Practitioner | 4624 S Holladay Blvd Ste 201, Slc, UT 84117-7168 | 2020-07-07 |
1124674460 | Kimberly Kae Weggemann Holder | Nurse Practitioner | 3018 E 3300 S, Slc, UT 84109-2144 | 2019-08-13 |
1598326084 | Nicole Ashley Lynch | Nurse Practitioner | 615 S Arapeen Dr Ste 100, Slc, UT 84108-1239 | 2019-06-25 |
Find all providers in SLC |
Please comment or provide details below to improve the information on GRACE-MAE CACHERO GENITIANO KELLY.
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.