Individual
KARLEE KAUFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4403 HARRISON BLVD STE 3680, OGDEN, UT 84403-3289
(801) 387-4750
Mailing address
4403 HARRISON BLVD STE 3680, OGDEN, UT 84403-3289
(801) 387-4750
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7187
AZ
363AS0400X
Surgical Physician Assistant
Primary
12966819-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12966819-1206
STATE OF UTAH DOPL
UT
01
—
12966819-8906
STATE OF UTAH DOPL CONTROLLED SUBSTANCE LICENSE
UT
01
—
7187
ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS
AZ
Enumeration date
10/24/2018
Last updated
08/31/2022
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