Healthcare Provider Details

I. General information

NPI: 1831759265
Provider Name (Legal Business Name): SARA M SWAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 S RIVER RD STE B105
ST GEORGE UT
84790-5704
US

IV. Provider business mailing address

720 S RIVER RD STE B105
ST GEORGE UT
84790-5704
US

V. Phone/Fax

Practice location:
  • Phone: 435-278-8227
  • Fax:
Mailing address:
  • Phone: 435-278-8227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number13091047-3502
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: