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

Marcia Kay Lidtke, FNP-C

Individual provider Family Nurse Practitioner · NPI 1972716496

Marcia Kay Lidtke, FNP-C is a Nurse Practitioner in Provo, Utah. Qualified in 2002, 24 years ago. Practices with Wasatch Behavioral Health Special Service District, a 82-clinician group and accepts Medicare assignment. Licensed in California and Utah.

Years since qualifying
24
Licensed in
CA, UT
In the registry since
2007
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

750 N Freedom Blvd
Provo, UT 84601-1677
Phone: (801) 373-9656
Fax: (801) 373-2978
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 9836853-4405 (UT)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 13626 (CA)

Record details

NPI number1972716496
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorYes
NPI enumeratedMay 8, 2007
Last updated in NPPESJanuary 19, 2017

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Wasatch Behavioral Health Special Service District — 82 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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