Individual
KRISTEN LILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1055 N 500 W STE 222, PROVO, UT 84604-3305
(801) 812-5033
Mailing address
1055 N 500 W, PROVO, UT 84604-3305
(801) 354-8225
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12227268-1204
UT
207RN0300X
Nephrology Physician
Primary
12227268-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2016
Last updated
08/31/2021
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