Healthcare Provider Details

I. General information

NPI: 1932881224
Provider Name (Legal Business Name): LAURA RENEE BEUS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1085 E GALENA DR
SANDY UT
84094-4021
US

IV. Provider business mailing address

9361 S 300 E
SANDY UT
84070-2902
US

V. Phone/Fax

Practice location:
  • Phone: 801-885-3483
  • Fax:
Mailing address:
  • Phone: 801-885-3483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number7187509-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: