Healthcare Provider Details

I. General information

NPI: 1992613244
Provider Name (Legal Business Name): MARIA DE LA LUZ CARRASCO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5316 S 2050 W
ROY UT
84067-2410
US

IV. Provider business mailing address

5316 S 2050 W
ROY UT
84067-2410
US

V. Phone/Fax

Practice location:
  • Phone: 385-887-4031
  • Fax:
Mailing address:
  • Phone: 385-887-4031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number126377243102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: