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General NPI Number Information
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NPI Number | 1245047190
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Entity Type | Organization
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Legal Business Name | RIDGELINE TERRACE PSYCHIATRY & WELLNESS LLC
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 01/01/2026
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Provider Practice Location Address
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Address Line | 250 N FAIRGROUNDS RD STE 3
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City | PRICE
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State | UT
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Zip | 84501-4201
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Country | US
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Telephone | 435-299-7083
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Fax | 435-637-2176
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Provider Business Mailing Address
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Address Line | 250 N FAIRGROUNDS RD STE 3
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City | PRICE
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State | UT
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Zip | 84501-4201
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Country | US
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Telephone | 435-299-7083
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Fax | 435-637-2176
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Authorized Official
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Title or Position | OWNER, OPERATOR
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Name | JESSICA GARNER
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Credential | APRN
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Telephone | 435-820-0730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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