MEDICARE: RACHEL BEYER RNFA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WR0006X	Registered Nurse First Assistant	5034796-3102	UT

General Provider Information

NPI Number	:	1588898852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL BEYER RNFA

Provider Business Mailing Address
First Line	:	6555 S 2365 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-2603
Country	:	US
Telephone Number	:	801-891-2954
Fax Number	:

Provider Business Practice Location Address
First Line	:	6555 S 2365 E
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-2603
Country	:	US
Telephone Number	:	801-891-2954
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2009
Last Update Date	:	05/14/2009

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