Healthcare Provider Details

I. General information

NPI: 1215858881
Provider Name (Legal Business Name): MEAGEN LOVELESS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

753 S 1040 W
PAYSON UT
84651-4643
US

IV. Provider business mailing address

451 TRAVERTINE WAY
SANTAQUIN UT
84655-7241
US

V. Phone/Fax

Practice location:
  • Phone: 385-506-2298
  • Fax:
Mailing address:
  • Phone: 801-885-0401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471R0002X
TaxonomyRadiation Therapy Radiologic Technologist
License Number9430116-5401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: