Individual
KELSIE BALMFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
(801) 373-0639
Mailing address
1152 E 350 N, OREM, UT 84097-5032
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
8602341-4405
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2017
Last updated
09/04/2019
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