Healthcare Provider Details

I. General information

NPI: 1659199784
Provider Name (Legal Business Name): ADAPTIVE HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2024
Last Update Date: 09/02/2025
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 N MAIN ST STE 101
CEDAR CITY UT
84721-9772
US

IV. Provider business mailing address

2202 N MAIN ST STE 101
CEDAR CITY UT
84721-9772
US

V. Phone/Fax

Practice location:
  • Phone: 435-865-1500
  • Fax: 435-383-4495
Mailing address:
  • Phone: 435-865-1500
  • Fax: 435-383-4495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: AMBER D DALTON
Title or Position: FAAMILY NURSSE PRACTITIONER / OWNER
Credential: FNP-C
Phone: 435-590-8322