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Contact Information

KELSEY GLEASON, PA-C
1055 N 500 W STE 121
PROVO, UT84604
 Phone: 801-373-7350
 Fax: 801-812-5401
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KELSEY GLEASON · (Female)

NPI Number 1205217890
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 06/09/2015
Last updated 11/27/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • UT License # 11085884-1206
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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