Healthcare Provider Details

I. General information

NPI: 1063211688
Provider Name (Legal Business Name): RACHEL WEBB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2025
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W HOSPITAL RD
BRIGHAM CITY UT
84302-3006
US

IV. Provider business mailing address

1260 21ST ST NW APT 511
WASHINGTON DC
20036-7313
US

V. Phone/Fax

Practice location:
  • Phone: 435-734-2041
  • Fax:
Mailing address:
  • Phone: 435-720-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number14230196-1206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: