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General NPI Number Information
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NPI Number | 1619748464
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Entity Type | Individual
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Provider Name | RACHEL GATHRO
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Gender | Female
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Dates
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Enumeration Date | 01/10/2024
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 763 N REDWOOD RD STE 110
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City | NORTH SALT LAKE
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State | UT
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Zip | 84054-2895
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Country | US
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Telephone | 801-292-1423
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Fax |
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Provider Business Mailing Address
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Address Line | 5233 W ARMADA WAY
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City | HERRIMAN
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State | UT
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Zip | 84096-8308
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Country | US
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Telephone | 801-885-0889
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 10837186-3102
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10837186-4405
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License Number State | UT
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