Healthcare Provider Details

I. General information

NPI: 1770628133
Provider Name (Legal Business Name): DEBORAH ADAMS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 WESTVIEW DR
RICHFIELD UT
84701-1868
US

IV. Provider business mailing address

340 N 300 E
MONROE UT
84754-4222
US

V. Phone/Fax

Practice location:
  • Phone: 435-896-5451
  • Fax: 435-896-4353
Mailing address:
  • Phone: 435-527-1333
  • Fax: 435-896-4353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number200387-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: