Carrie Idamae Bistline

Individual provider Active NPI Community Health Worker · St George, UT

NPI 1205565173 · NPPES record last updated Jun 7, 2022

Key facts

NPI
1205565173
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
474 W 200 N # 300
St George, UT 84770-4505
Phone
(435) 634-5600
Fax
(435) 986-8700
NPI assigned
Jun 7, 2022
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
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

474 W 200 N # 300
St George, UT 84770-4505

Mailing address

474 W 200 N # 300
St George, UT 84770-4505
Phone (435) 634-5600

Other names

  • Carrie Idamae Pipkin Former name

Other providers in St George, UT

All providers in St George, UT · Community Health Worker in Utah

Sources for this page

Verify at the official NPI Registry.