Healthcare Provider Details

I. General information

NPI: 1316879984
Provider Name (Legal Business Name): CACIA LIN BILLINGS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 9TH AVE S
BIRMINGHAM AL
35233-1124
US

IV. Provider business mailing address

225 SUMMIT DR
SMITHFIELD UT
84335-1114
US

V. Phone/Fax

Practice location:
  • Phone: 435-232-9786
  • Fax:
Mailing address:
  • Phone: 435-232-9786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: