Healthcare Provider Details

I. General information

NPI: 1578420881
Provider Name (Legal Business Name): KATHRINE RENAE WEBB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE RENAE WEBB REGISTERED NURSE

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3848 HARRISON BLVD
OGDEN UT
84408-0001
US

IV. Provider business mailing address

4914 W 4600 S
WEST HAVEN UT
84401-9212
US

V. Phone/Fax

Practice location:
  • Phone: 801-626-6000
  • Fax:
Mailing address:
  • Phone: 254-226-2556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number10500303-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: