Healthcare Provider Details

I. General information

NPI: 1013346634
Provider Name (Legal Business Name): ALEC HIGGINS RIMMASCH JR. NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AJ RIMMASCH NP-C

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 11/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 N 100 W STE 104
VERNAL UT
84078-2054
US

IV. Provider business mailing address

175 N 100 W STE 104
VERNAL UT
84078-2054
US

V. Phone/Fax

Practice location:
  • Phone: 435-781-3053
  • Fax: 435-781-3055
Mailing address:
  • Phone: 435-781-3053
  • Fax: 435-781-3055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6590438-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: