Healthcare Provider Details

I. General information

NPI: 1306801949
Provider Name (Legal Business Name): REBEKAH AMY PATTERSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 N MAIN ST
RICHFIELD UT
84701-1841
US

IV. Provider business mailing address

PO BOX 353 185 WEST 300 SO.
ANNABELLA UT
84711-0353
US

V. Phone/Fax

Practice location:
  • Phone: 435-896-9561
  • Fax: 435-896-9564
Mailing address:
  • Phone: 435-896-9561
  • Fax: 435-896-9564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number328676-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: