MEDICARE: ABBY GAIL HARRIS MDA, RDN

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	133V00000X	Registered Dietitian	14255308-4901	UT

General Provider Information

NPI Number	:	1659223287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBY GAIL HARRIS MDA, RDN

Provider Business Mailing Address
First Line	:	1407 N 3500 W
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84601-6213
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1407 N 3500 W
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84601-6213
Country	:	US
Telephone Number	:	435-421-4637
Fax Number	:

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

Provider Enumeration Date	:	02/14/2026
Last Update Date	:	02/14/2026

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