| Kindly Md, Inc. | |
|
5097 S 900 E Ste 100 Millcreek UT 84117-5725 | |
| (801) 851-5554 | |
| (833) 464-2575 |
| Full Name | Kindly Md, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 5097 S 900 E Ste 100, Millcreek, Utah |
| Authorized Official Name and Position | Amy Cowan (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 8018515554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kindly Md, Inc. 5097 S 900 E Salt Lake Cty UT 84117-5768 Ph: (801) 851-5554 | Kindly Md, Inc. 5097 S 900 E Ste 100 Millcreek UT 84117-5725 Ph: (801) 851-5554 |
| NPI Number | 1225647480 |
|---|---|
| Provider Enumeration Date | 07/23/2020 |
| Last Update Date | 08/24/2023 |
| Medicare PECOS PAC ID | 8921471897 |
|---|---|
| Medicare Enrollment ID | O20230224001420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225647480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Eva Losaline Tukuafu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255713582 PECOS PAC ID: 7214218221 Enrollment ID: I20170106000427 |
| Provider Name | Jamie L Bustamante |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982097127 PECOS PAC ID: 3779898747 Enrollment ID: I20170616001956 |
| Provider Name | Shane S. Jaimez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780156661 PECOS PAC ID: 0749510931 Enrollment ID: I20191002000382 |
| Provider Name | Beth Silvero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053965509 PECOS PAC ID: 9638507296 Enrollment ID: I20200312001743 |
| Provider Name | Charles Arena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164664637 PECOS PAC ID: 5092118133 Enrollment ID: I20230322001204 |
| Provider Name | Nancy E Pratt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750726196 PECOS PAC ID: 6204368301 Enrollment ID: I20241014004447 |
| Provider Name | Michael Christian Woodhead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427896083 PECOS PAC ID: 8820518715 Enrollment ID: I20250221002620 |
| Provider Name | Kristy Brubaker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760857288 PECOS PAC ID: 0244751972 Enrollment ID: I20250310003068 |
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