Healthcare Provider Details
I. General information
NPI: 1386508752
Provider Name (Legal Business Name): STILLPOINT WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 11/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
701 S MAIN ST STE 100
LOGAN UT
84321-5765
US
IV. Provider business mailing address
701 S MAIN ST STE 100
LOGAN UT
84321-5765
US
V. Phone/Fax
- Phone: 435-395-5993
- Fax:
- Phone: 435-395-5993
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAQUEL
RUGGIERO
Title or Position: OWNER PMHNP
Credential: NP
Phone: 435-395-5993