Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Katie Elaine Ridge McKinnon

Individual provider Physician Assistant · NPI 1811624513

Katie Elaine Ridge McKinnon is a Physician Assistant in Provo, Utah. Licensed in Utah. Registered with an NPI since 2022.

Licensed in
UT
In the registry since
2022

Practice location Address checks out

1900 N State St Ste 105
Provo, UT 84604-1354
Phone: (801) 655-5245
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 13072448-1206 (UT)

Record details

NPI number1811624513
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 2, 2022
Last updated in NPPESJanuary 8, 2023
Certification dateJanuary 8, 2023

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