MEDICARE: ABBY EVANS

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	235Z00000X	Speech-Language Pathologist		UT

General Provider Information

NPI Number	:	1568397214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBY EVANS

Provider Business Mailing Address
First Line	:	2620 E NANTUCKET DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-5621
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1960 SIDEWINDER DR STE 106
Second Line	:
City	:	PARK CITY
State	:	UT
Zip	:	84060-7361
Country	:	US
Telephone Number	:	801-824-5057
Fax Number	:

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

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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Directions to “ ABBY EVANS ” Practice Location

Language	Start Address	Practice Location

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