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

Keith Thomas Petagna

Individual provider Community Health Worker · NPI 1992499362

Keith Thomas Petagna is a Community Health Worker in Salt Lake City, Utah. Licensed in Utah. Registered with an NPI since 2023.

Licensed in
UT
In the registry since
2023
Specialties on file
2

Practice location Address checks out

443 S 600 E
Salt Lake City, UT 84102-2708
Phone: (801) 536-6523
Show map & directions

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

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X · Licence F24-112623 (UT)
Community Health Worker Taxonomy 172V00000X

Record details

NPI number1992499362
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 7, 2023
Last updated in NPPESOctober 17, 2024
Certification dateOctober 17, 2024

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