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1700020369
DEIDRA DAWN BACON
ST GEORGE, UT
NPI
1700020369
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: UT 197702-4405)
Enumeration Date
2009-04-27
Last Update Date
2021-08-10
Business Address
DEIDRA DAWN BACON APRN, FNP-BC
577 S RIVER RD
ST GEORGE, UT 84790-2097
Phone number: 435-688-6000
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Mailing Address
DEIDRA DAWN BACON APRN, FNP-BC
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number:
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