MEDICARE: BROCK FREIDENBERGER PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	14192566-4405	UT

General Provider Information

NPI Number	:	1942022827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROCK FREIDENBERGER PMHNP

Provider Business Mailing Address
First Line	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 E 1400 N STE T
Second Line	:
City	:	LOGAN
State	:	UT
Zip	:	84341-2450
Country	:	US
Telephone Number	:	435-716-1320
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2024
Last Update Date	:	01/06/2026

Similar Medicare Providers

1821477951 — REGINA RENEE DICKINSON LCSW
Practice Location Address:

550 E 1400 N STE T
LOGAN, UT
84341-2450

Practice Phone: 435-716-1320
Practice Fax:

1033156849 — BRANT WAHLEN FONNESBECK DO
Practice Location Address:

550 E 1400 N STE K
LOGAN, UT
84341-2450

Practice Phone: 435-755-6061
Practice Fax:

1316989569 — W BRYCE COOK DPM
Practice Location Address:

550 E 1400 N , STE B
LOGAN, UT
84341-2450

Practice Phone: 435-752-9011
Practice Fax: 435-752-7159

1922024959 — MR. GREGG R LUKE R.PH.
Practice Location Address:

550 E 1400 N STE K
NORTH LOGAN, UT
84341-2450

Practice Phone: 435-755-8424
Practice Fax: 453-755-8436

1245305689 — IHC HEALTH SERVICES INC
Practice Location Address:

550 E 1400 N STE G
LOGAN, UT
84341-2450

Practice Phone: 435-716-5477
Practice Fax:

1558436980 — IHC HEALTH SERVICES INC
Practice Location Address:

550 E 1400 N STE G
LOGAN, UT
84341-2450

Practice Phone: 435-716-5477
Practice Fax:

Directions to “ BROCK FREIDENBERGER PMHNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.