Individual
REBECCA HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
395 E COUGAR BLVD, 101, PROVO, UT 84604-8460
(801) 357-7850
Mailing address
395 W COUGAR BLVD STE 101, PROVO, UT 84604-3334
(801) 357-7850
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5497556-4405
UT
Other
Enumeration date
08/02/2018
Last updated
03/11/2021
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