Healthcare Provider Details

I. General information

NPI: 1952280257
Provider Name (Legal Business Name): RACHEL SHEEHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

552 W 800 N
OREM UT
84057-3746
US

IV. Provider business mailing address

3959 STADIUM WAY
OGDEN UT
84408-0001
US

V. Phone/Fax

Practice location:
  • Phone: 801-764-0200
  • Fax:
Mailing address:
  • Phone: 801-626-7210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1952280257
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: