Leticia Bench Wasden, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8668341-4405 Issued in UT

Practice address

773 E Mill Rd Ste C
Vineyard, UT 84059-5772

Phone

(801) 864-2693

NPI assigned

Jul 13, 2023

Last updated

Jul 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1932888237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N 20 W",
            "city": "VINEYARD",
            "state": "UT",
            "postal_code": "840596557",
            "telephone_number": "801-473-9798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773 E MILL RD STE C",
            "city": "VINEYARD",
            "state": "UT",
            "postal_code": "840595772",
            "telephone_number": "801-864-2693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASDEN",
        "first_name": "LETICIA",
        "middle_name": "BENCH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8668341-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vineyard Oral and Maxillofacial Surgery
• Vineyard Surgery Center, LLC (Vineyard Medical Group)
• Vineyard Surgery Center, LLC
• Rebecca Ann Waite, APRN
• Connan Wallace, PT, DPT
• Bryan Weed, MD
• Brett Wheatfill, FNP
• Wholebility
• Bailey Wilson, PA-C
• David Wilson, PHARMD

• Family Nurse Practitioner in Vineyard, UT
• Providers in Vineyard, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.