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Organization

BRADES' PLACE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
REBECCA RAE OAKLEY FNP (EXECUTIVE DIRECTOR)
(801) 368-4499
Entity
Organization

Contact information

Practice address
417 S PALISADES DR, OREM, UT 84097-6694
(801) 368-4499
Mailing address
417 S PALISADES DR, OREM, UT 84097-6694
(801) 368-4499

Taxonomy

Speciality
Code
Description
License number
State
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
363LF0000X
Family Nurse Practitioner
Primary
363LP0200X
Pediatric Nurse Practitioner

Other

Enumeration date
08/16/2021
Last updated
08/16/2021
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