Deidra Dawn Bacon, APRN, FNP-BC
Nurse Practitioner in St George, UT. Individual provider (NPI-1).
NPI number1700020369
StatusActive
Last updated in NPPESApr 13, 2026
Details
- NPI
- 1700020369
- Entity type
- Individual (NPI-1)
- Name
- Deidra Dawn Bacon
- Credential
- APRN, FNP-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 27, 2009
- Certification date
- Apr 13, 2026
- Last updated
- Apr 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 197702-4405 | UT | Yes |
| 363LF0000X | Nurse Practitioner, Family | 197702-4405 | UT |
Practice location
1380 E Medical Center DrSt George, UT 84790-2123
Phone 435-688-4293
Mailing address
Po Box 27128Salt Lake City, UT 84127-0128
Other practice locations
577 S River Rd
St George, UT 84790-2097
St George, UT 84790-2097
Phone 435-688-6000
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