Healthcare Provider Details

I. General information

NPI: 1720808637
Provider Name (Legal Business Name): MRS. RACHEL B EDWARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 N 2550 W
WEST POINT UT
84015-4813
US

IV. Provider business mailing address

195 N 1950 W
SLC UT
84116-3100
US

V. Phone/Fax

Practice location:
  • Phone: 801-368-8557
  • Fax:
Mailing address:
  • Phone: 801-368-8557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: