Healthcare Provider Details

I. General information

NPI: 1487815650
Provider Name (Legal Business Name): AMANDA M. CLEVELAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA M. TIPTON MD

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 08/16/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 N 1200 W UNIT 2034
LAYTON UT
84041-5716
US

IV. Provider business mailing address

1706 N 1200 W UNIT 2034
LAYTON UT
84041-5716
US

V. Phone/Fax

Practice location:
  • Phone: 801-876-5166
  • Fax: 801-931-6226
Mailing address:
  • Phone: 801-876-5166
  • Fax: 801-931-6226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number98326551205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: