Individual
KENDRA STAHELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, PMHNP-BC
Contact information
Practice address
395 W BULLDOG BLVD STE 601, PROVO, UT 84604-3331
(801) 357-7525
(801) 357-7746
Mailing address
395 W COUGAR BLVD STE 601, PROVO, UT 84604-3331
(801) 357-7525
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8632096-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
8632096-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
8632096-8900
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
UT
Enumeration date
07/11/2019
Last updated
09/29/2021
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