Healthcare Provider Details

I. General information

NPI: 1568638245
Provider Name (Legal Business Name): MRS. ANNETTE GOTCHY NAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 S 1175 W
CEDAR CITY UT
84720-3699
US

IV. Provider business mailing address

66 W HARDING AVE SUITE # 2
CEDAR CITY UT
84720-2695
US

V. Phone/Fax

Practice location:
  • Phone: 435-590-7568
  • Fax: 270-778-9215
Mailing address:
  • Phone: 435-590-7568
  • Fax: 270-778-9215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number5027458-6009
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: