NPI 1689145963 · live from the CMS NPI Registry
Anew Clinical Practitioners PLLC
Nurse Practitioner, Psych/Mental Health in Draper, UT. National Provider Identifier 1689145963, active.
NPI record
| NPI | 1689145963 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Psych/Mental Health 363LP0808X |
| Practice location | 11762 S State St Ste 160, Draper, UT 84020 |
| Practice phone | 801-654-3229 |
| Enumerated | December 11, 2018 |
| Last updated | June 17, 2020 |
| Authorized official | Tamara Broadhead, Owner/Medical Director |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Family | 363LF0000X | — |
| Nurse Practitioner, Psych/Mental Health primary | 363LP0808X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.