Healthcare Provider Details

I. General information

NPI: 1235056748
Provider Name (Legal Business Name): IRENE WARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E 620 S UNIT B114
AMERICAN FORK UT
84003-5013
US

IV. Provider business mailing address

800 E 620 S UNIT B114
AMERICAN FORK UT
84003-5013
US

V. Phone/Fax

Practice location:
  • Phone: 801-810-6531
  • Fax:
Mailing address:
  • Phone: 801-810-6531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberUT14875-123007
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: