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

Kyrstanne Kaye Idom, PA

Individual provider Physician Assistant · NPI 1659248953

Kyrstanne Kaye Idom, PA is a Physician Assistant in Grantsville, Utah. Licensed in Utah. Registered with an NPI since 2025.

Licensed in
UT
In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

228 S Tawny Dr
Grantsville, UT 84029-5028
Phone: (801) 580-9139
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (UT)

Record details

NPI number1659248953
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 21, 2025
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025

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