Healthcare Provider Details

I. General information

NPI: 1457174427
Provider Name (Legal Business Name): KARA NICHOLE LEAVITT NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARA NICHOLE OVIATT RN

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 N 500 W
PROVO UT
84604-3337
US

IV. Provider business mailing address

60 W 650 N
LINDON UT
84042-1355
US

V. Phone/Fax

Practice location:
  • Phone: 801-357-7414
  • Fax:
Mailing address:
  • Phone: 801-874-6842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number8281553-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: