Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jessie Haderlie

Individual provider Psychiatric/Mental Health Registered Nurse · NPI 1699509257

Jessie Haderlie is a Nurse Practitioner in West Jordan, Utah. Qualified in 2025, 1 year ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
1
Licensed in
UT
In the registry since
2024
Specialties on file
2

Practice location Address checks out

5573 W Bluevail Ct
West Jordan, UT 84081-5226
Phone: (801) 419-9365
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Registered Nurse (primary) Taxonomy 163WP0808X · Licence 11767125-4405 (UT)
Adult Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0809X · Licence 11767125-3102 (UT)

Record details

NPI number1699509257
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 27, 2024
Last updated in NPPESNovember 20, 2025
Certification dateNovember 20, 2025
Mailing address5573 W Bluevail Ct, West Jordan, UT 84081-5226

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in West Jordan