MARCIA KAY LIDTKE

PROVO, UT
NPI1972716496
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: UT  9836853-4405)
Additional Taxonomies363LF0000X Nurse Practitioner, Family
(Licence: CA  13626)
Enumeration Date2007-05-08
Last Update Date2017-01-19
Business Address
-- MARCIA KAY LIDTKE FNP-c
750 N FREEDOM BLVD
PROVO, UT 84601-1677
Phone number: 801-373-9656
Mailing Address
-- MARCIA KAY LIDTKE FNP-c
23 E EMERALD CT
SARATOGA SPRINGS, UT 84045-8141
Phone number: 408-813-0780