Provider Demographics
NPI:1447061114
Name:HALVORSEN, NAOMI
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:HALVORSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6105 S RIMRUNNER DR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-1238
Mailing Address - Country:US
Mailing Address - Phone:801-648-2307
Mailing Address - Fax:
Practice Address - Street 1:6105 S RIMRUNNER DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-1238
Practice Address - Country:US
Practice Address - Phone:801-648-2307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer