Individual
KYLIE RUTH FACKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
617 E RIVERSIDE DR STE 301, ST GEORGE, UT 84790-8722
(435) 216-7000
Mailing address
617 E RIVERSIDE DR, STE 301, ST GEORGE, UT 84790-8722
(435) 216-7000
(435) 216-7001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/03/2019
Last updated
10/29/2019
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