Healthcare Provider Details

I. General information

NPI: 1962348250
Provider Name (Legal Business Name): MCKENNA COWLEY STUBBS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1472 S 800 W
CEDAR CITY UT
84720-4379
US

IV. Provider business mailing address

1472 S 800 W
CEDAR CITY UT
84720-4379
US

V. Phone/Fax

Practice location:
  • Phone: 435-592-1880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number14197666-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: