Kidist Fisseha, | |
1633 W Innovation Way Fl 4, Lehi, UT 84043-4252 | |
(855) 726-6363 | |
(801) 784-1482 |
Full Name | Kidist Fisseha |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 1633 W Innovation Way Fl 4, Lehi, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356032262 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 1009883 (Texas) | Secondary |
363LF0000X | Nurse Practitioner - Family | 9115682-4405 (Utah) | Primary |
Entity Name | Wellbe Utah Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568183523 PECOS PAC ID: 6002292034 Enrollment ID: O20220928003465 |
Mailing Address | Practice Location Address |
---|---|
Kidist Fisseha, 1633 W Innovation Way Fl 4, Lehi, UT 84043-4252 Ph: (855) 726-6363 | Kidist Fisseha, 1633 W Innovation Way Fl 4, Lehi, UT 84043-4252 Ph: (855) 726-6363 |
Hanford Blitch Shuman, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2183 W Main St Ste A107, Lehi, UT 84043 Phone: 385-203-1215 Fax: 801-655-5217 | |
Rebecca Dawn Roy, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1850 W Ashton Blvd Ste 100, Lehi, UT 84043 Phone: 801-514-7650 Fax: 801-206-3656 | |
Bremond White, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4151 N Traverse Mtn Blvd # 19-001, Lehi, UT 84043 Phone: 801-440-0260 | |
Mrs. Morgan D'arcy Behling, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2183 W Main St Ste A107, Lehi, UT 84043 Phone: 385-203-1215 | |
Isabel Santos Sanchez, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3000 N Triumph Blvd Ste 260, Lehi, UT 84043 Phone: 801-357-7499 | |
Jamie Lyn Lange, MSN, APRN, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1431 W 350 S, Lehi, UT 84043 Phone: 765-506-8042 | |
Stephen Berendson, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2506 W 2400 N, Lehi, UT 84043 Phone: 801-372-3889 |