Healthcare Provider Details

I. General information

NPI: 1962178681
Provider Name (Legal Business Name): RACHEL NEBEKER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2021
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5475 S 500 E
OGDEN UT
84405-6905
US

IV. Provider business mailing address

659 HALIFAX CT
FARMINGTON UT
84025-4204
US

V. Phone/Fax

Practice location:
  • Phone: 800-880-3566
  • Fax:
Mailing address:
  • Phone: 612-859-4145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number250728
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number9655869-8901
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number9655869-8901
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: