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

Mackenzie Ridley, PA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1053101378

Mackenzie Ridley, PA is a Student in an Organized Health Care Education/Training Program in Provo, Utah. Registered with an NPI since 2025.

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.

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Practice location Address checks out

1800 Novell Pl
Provo, UT 84606-6171
Phone: (801) 375-5125
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1053101378
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 9, 2025
Last updated in NPPESMay 9, 2025
Certification dateMay 9, 2025
Mailing address1800 Novell Pl, Provo, UT 84606-6171

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