Healthcare Provider Details

I. General information

NPI: 1326901083
Provider Name (Legal Business Name): RIAN FREDERICK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

528 N 1000 E
SPANISH FORK UT
84660-1645
US

IV. Provider business mailing address

528 N 1000 E
SPANISH FORK UT
84660-1645
US

V. Phone/Fax

Practice location:
  • Phone: 509-528-4072
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number117376274405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: