IndividualActive
Kelly Daly-Wolfe, PA-C, RDN
NPI 1003334525 · Medical Physician Assistant · Provo, UT
Provider details
- NPI number
- 1003334525
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C, RDN
- Sex
- Female
- Sole proprietor
- Yes
- License
- 8423560-1206 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
750 N 200 W
Provo, UT 84601-1677
Phone: (801) 429-2000
Approximate (ZIP-level) locationGet directions
Mailing address
589 S State St
Provo, UT 84606-5056
Registry dates
- Enumerated
- 2017-09-05
- Last updated
- 2024-05-20
- Certified
- 2024-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.