KIDIST FISSEHA NPI 1356032262

NPI Information

  • NPI: 1356032262
  • Provider Name: KIDIST FISSEHA
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1633 W INNOVATION WAY FL 4
    LEHI, UT
    ZIP 84043
  • Phone: (855) 726-6363

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NPI Details

Kidist Fisseha is a family nurse practitioner in Lehi, UT. Kidist Fisseha NPI is 1356032262. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1633 W INNOVATION WAY FL 4
LEHI, UT
ZIP 84043-252
Phone: (855) 726-6363
Fax: (801) 784-1482

The NPI 1356032262 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/19/2023 and was last updated on 7/25/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse1009883TEXASNo
2363LF0000XNurse PractitionerFamily9115682-4405UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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