Healthcare Provider Details

I. General information

NPI: 1275134132
Provider Name (Legal Business Name): BRANDY MARIE FAMILY & AESTHETIC CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 01/18/2026
Certification Date: 01/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1448 N 2000 W STE 3
CLINTON UT
84015-8388
US

IV. Provider business mailing address

1448 N 2000 W STE 3
CLINTON UT
84015-8388
US

V. Phone/Fax

Practice location:
  • Phone: 801-866-5353
  • Fax: 801-516-0977
Mailing address:
  • Phone: 801-866-5353
  • Fax: 801-516-0977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRANDY M TAFOYA
Title or Position: OWNER/FAMILY NURSE PRACTITIONER
Credential: APRN-C
Phone: 801-866-5353