Individual provider Active NPI

Kaisley Nan Christensen

  • Family Nurse Practitioner
  • Draper, UT
National Provider Identifier
1396552188
Registry record updated Feb 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12324627-4405 Issued in UT
Practice address
11762 S State St Ste 320
Draper, UT 84020-7166
Phone
(801) 380-3894
NPI assigned
Dec 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 12324627-3102 UT
Family Nurse Practitioner 363LF0000X 12324627-4405 UT Primary

Addresses

Primary practice location

11762 S State St Ste 320
Draper, UT 84020-7166

Mailing address

11762 S State St Ste 320
Draper, UT 84020-7166

Other practice location 1

728 S 300 W
Salem, UT 84653-9132
Phone (801) 380-3894

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12324627-3102UTMDRegistered Nurse
12324627-4405UTMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739059200000",
    "number": "1396552188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11762 S STATE ST STE 320",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11762 S STATE ST STE 320",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207166",
            "telephone_number": "801-380-3894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "728 S 300 W",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "UT",
            "postal_code": "846539132",
            "country_code": "US",
            "telephone_number": "801-380-3894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "KAISLEY",
        "middle_name": "NAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-16",
        "last_updated": "2025-02-09",
        "certification_date": "2025-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "12324627-3102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "12324627-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.