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General NPI Number Information
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NPI Number | 1871364760
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Entity Type | Individual
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Provider Name | TARA LYN RHODES NP
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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 | 01/30/2026
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Provider Practice Location Address
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Address Line | 550 E 1400 N STE S
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City | LOGAN
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State | UT
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Zip | 84341-2450
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Country | US
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Telephone | 435-716-1860
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27128
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City | SALT LAKE CITY
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State | UT
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Zip | 84127-0128
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 7677239-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 7677239-3102
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License Number State | UT
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