IndividualActive
Rebecca Wallace, APRN
NPI 1104810134 · Family Nurse Practitioner · Salt Lake City, UT
Provider details
- NPI number
- 1104810134
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- License
- 216162-4405 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3838 S 700 E
Suite 200
Salt Lake City, UT 84106-1466
Phone: (801) 261-4988
Fax: (801) 269-9427
Street-level locationGet directions
Mailing address
1837 Hollywood Ave
Salt Lake City, UT 84108-3103
Registry dates
- Enumerated
- 2005-09-06
- Last updated
- 2008-11-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.