Individual provider · Type 1 NPI

Heidi Gretchen Tidwell

Student in an Organized Health Care Education/Training Program · Salt Lake City, UT

NPI number 1912813775 Active

Practice location

1537 S Main St
Salt Lake City, UT 84115-5315

Call (801) 870-2112 Map

Mailing address

1731 S Bambrough Pl
Salt Lake City, UT 84108-3075

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1912813775

Heidi Gretchen Tidwell's National Provider Identifier is 1912813775, issued on Aug 21, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Salt Lake City, UT. The record was last updated on Aug 21, 2026.