Healthcare Provider Details

I. General information

NPI: 1417814906
Provider Name (Legal Business Name): MS. MARILYN ALLRED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 W JORDAN NARROWS RD
BLUFFDALE UT
84065-1869
US

IV. Provider business mailing address

1420 W JORDAN NARROWS RD
BLUFFDALE UT
84065-1869
US

V. Phone/Fax

Practice location:
  • Phone: 435-610-0395
  • Fax:
Mailing address:
  • Phone: 435-610-0395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: