Healthcare Provider Details

I. General information

NPI: 1033023528
Provider Name (Legal Business Name): MARIA MICHELLE WILLIFORD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3946 SUMMER RIDGE RD
MORGAN UT
84050-9341
US

IV. Provider business mailing address

3946 SUMMER RIDGE RD
MORGAN UT
84050-9341
US

V. Phone/Fax

Practice location:
  • Phone: 801-845-0693
  • Fax:
Mailing address:
  • Phone: 801-845-0693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number14203618-3102
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: