MEDICARE: DOMINIQUE FAITH GARAY RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	119235563102	UT

General Provider Information

NPI Number	:	1003748658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINIQUE FAITH GARAY RN

Provider Business Mailing Address
First Line	:	9980 S 300 W STE 150
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84070-3651
Country	:	US
Telephone Number	:	801-999-4860
Fax Number	:

Provider Business Practice Location Address
First Line	:	9980 S 300 W STE 150
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84070-3651
Country	:	US
Telephone Number	:	801-999-4860
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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Directions to “ DOMINIQUE FAITH GARAY RN” Practice Location

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