KYRSTANNE IDOM, PA
Physician Assistant
Active
Individual
NPI: 1659248953
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant | 363A00000X | Yes | - |
Frequently Asked Questions
NPI 1659248953 is the National Provider Identifier for KYRSTANNE IDOM, PA, a Physician Assistant provider located in Grantsville, UT. This NPI was enumerated on October 21, 2025.
KYRSTANNE IDOM, PA practices at 228 S TAWNY DR, Grantsville, UT 84029.
Quick Facts
- NPI
- 1659248953
- Type
- Individual
- Enumerated
- Oct 21, 2025
- Last Updated
- Oct 21, 2025
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