Kacie Dickson

Individual provider Active NPI Family Nurse Practitioner · West Haven, UT

NPI 1114840980 · NPPES record last updated Jul 30, 2026

Key facts

NPI
1114840980
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
9267027-4405 (UT)
Practice address
4679 W 4500 S
West Haven, UT 84401-9396
Phone
(435) 640-8106
Fax
(435) 640-8106
NPI assigned
Jul 30, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9267027-4405 UT Yes

Addresses

Primary practice location

4679 W 4500 S
West Haven, UT 84401-9396

Mailing address

4679 W 4500 S
West Haven, UT 84401-9396

Other providers in West Haven, UT

All providers in West Haven, UT · Family Nurse Practitioner in Utah

Sources for this page

Verify at the official NPI Registry.