Raquel Wall, Nurse Practitioner
Nurse Practitioner, Family in Saint George, UT. Individual provider (NPI-1).
NPI number1164036265
StatusActive
Last updated in NPPESJul 11, 2024
Details
- NPI
- 1164036265
- Entity type
- Individual (NPI-1)
- Name
- Raquel Wall
- Credential
- Nurse Practitioner
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 4, 2020
- Certification date
- Jul 11, 2024
- Last updated
- Jul 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 217908-4405 | UT | Yes |
Practice location
1490 E Foremaster Dr Ste 320Saint George, UT 84790-4505
Phone 435-359-3115 · Fax 435-319-7123
Mailing address
1490 E Foremaster Dr Ste 320Saint George, UT 84790-4505
Phone 435-359-3115 · Fax 435-319-7123
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