Individual
MR. KELLY BRYAN GINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
444 W BOURNE CIR STE 200, FARMINGTON, UT 84025-3657
(801) 776-0174
(801) 825-3904
Mailing address
2044 N 3700 W, PLAIN CITY, UT 84404-9485
(801) 458-0889
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
8334395
UT
363LF0000X
Family Nurse Practitioner
Primary
8334395-4405
UT
Other
Enumeration date
06/29/2018
Last updated
06/09/2022
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