Healthcare Provider Details

I. General information

NPI: 1255174744
Provider Name (Legal Business Name): RACHAEL KRISTINE REDFORD AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MEDICAL DR STE A202
BOUNTIFUL UT
84010-4971
US

IV. Provider business mailing address

415 MEDICAL DR STE A202
BOUNTIFUL UT
84010-4971
US

V. Phone/Fax

Practice location:
  • Phone: 801-298-4327
  • Fax: 801-298-4328
Mailing address:
  • Phone: 801-298-4327
  • Fax: 801-298-4328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number5182000-4101
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number5182000-4101
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: