Healthcare Provider Details

I. General information

NPI: 1881501609
Provider Name (Legal Business Name): MADISON RUMSEY CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 S COTTONWOOD ST
MURRAY UT
84107-5701
US

IV. Provider business mailing address

8883 S DANISH RD
SANDY UT
84093-2105
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-2384
  • Fax:
Mailing address:
  • Phone: 801-507-2384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number13995842-3601
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: