GRACE-MAE CACHERO GENITIANO KELLY NPI 1265916639

NPI Information

Grace-mae Cachero Genitiano Kelly is a family nurse practitioner in Slc, UT with 5 years of experience. Grace-mae Cachero Genitiano Kelly NPI is 1265916639. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4460 S HIGHLAND DR
SLC, UT
ZIP 84124-543
Phone: (888) 949-4864

The NPI 1265916639 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/20/2018 and was last updated on 11/1/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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