Healthcare Provider Details

I. General information

NPI: 1629988498
Provider Name (Legal Business Name): RACHEL VICTORIA BOWEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2046 E MURRAY HOLLADAY RD STE 101
HOLLADAY UT
84117-5173
US

IV. Provider business mailing address

2930 S ADAMS ST
SOUTH SALT LAKE UT
84115-4002
US

V. Phone/Fax

Practice location:
  • Phone: 801-980-2566
  • Fax:
Mailing address:
  • Phone: 801-598-6049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: