Individual
RAISSA DE SOUSA FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5983 S REDWOOD RD, TAYLORSVILLE, UT 84123-5261
(435) 655-1141
Mailing address
7376 S SHELBY VIEW DR, MIDVALE, UT 84047-5663
(435) 655-1141
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
141901203102
UT
Other
Enumeration date
08/29/2025
Last updated
08/29/2025
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