DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

BREANNA BRADLEY BLACK, PA-C

Active

Physician Assistant · PROVO, UT

Registration Details

NPI Number
1346972502
Provider Type
Individual
Gender
Female
NPI Issued
Jun 27, 2022 (3.8465192984214 yrs)
Last Updated
Oct 3, 2023
License
13603008-1206 (UT)

Practice Information

Address
1055 N 500 W BLDG A
PROVO, UT, 846043305
Browse UT providers · Browse ZIP 84604
Phone
8018125033
Fax
8014180941
Primary Specialty
Physician Assistant
363A00000X

Other Physician Assistant Providers in PROVO, UT

Name Credential NPI
JEFFREY D PIERSON PA-C 1861490609
BRET D HILTON PA 1467451609
STEVEN R NIELSON PA 1184623217
JOHN ZACHARY PA 1871580829
JOHN A WHITEHEAD PA 1619935053
CORY NATHANAEL MILLER PA 1346298510
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.