Healthcare Provider Details

I. General information

NPI: 1518528199
Provider Name (Legal Business Name): RACHEL EMMELINE KING APRN, DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 10/21/2022
Certification Date: 09/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3409 W 12600 S STE 230
RIVERTON UT
84065-7270
US

IV. Provider business mailing address

3409 W 12600 S STE 230
RIVERTON UT
84065-7270
US

V. Phone/Fax

Practice location:
  • Phone: 801-252-6116
  • Fax:
Mailing address:
  • Phone: 801-252-6116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8598712-4405
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: