| Kelsey Dietrich, MSN, FNP-BC | |
|
324 E 10th Ave Ste 200, Salt Lake City, UT 84103-2869 | |
| (801) 408-7660 | |
| Not Available |
| Full Name | Kelsey Dietrich |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 324 E 10th Ave Ste 200, Salt Lake City, Utah |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013619857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 12764506-3102 (Utah) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 12764506-4405 (Utah) | Primary |
| Entity Name | Ihc Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelsey Dietrich, MSN, FNP-BC 1477 S 500 E, Salt Lake City, UT 84105-2046 Ph: (810) 869-6378 | Kelsey Dietrich, MSN, FNP-BC 324 E 10th Ave Ste 200, Salt Lake City, UT 84103-2869 Ph: (801) 408-7660 |
Mrs. Lisa Ann Runyon, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Trauma Services, Salt Lake City, UT 84113 Phone: 801-662-2993 Fax: 801-662-2999 | |
Donna M. Wahoff-stice, APRN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 615 Arapeen Dr, 100, Salt Lake City, UT 84108 Phone: 801-581-7761 | |
Linda M Lambert, A.P.R.N. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Salt Lake City, UT 84113 Phone: 801-662-1000 | |
Ms. Ann A. K. Kamp, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Salt Lake City, UT 84113 Phone: 801-662-1000 Fax: 801-662-4166 | |
Sarah Zobell, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-1619 | |
Mrs. Giovana Martendal King, NNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-4100 | |
Alicia Donaldson, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 N Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-1000 |