Healthcare Provider Details

I. General information

NPI: 1538900337
Provider Name (Legal Business Name): DR. REBECCA RACHEL EATON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA R EATON WHNP CNM DNP

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9450 S 1300 E
SANDY UT
84094-5553
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-501-2160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number338773-3102
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number338773-3102
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number338773-4402
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number338773-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: