Healthcare Provider Details

I. General information

NPI: 1912427139
Provider Name (Legal Business Name): BRITTANY KAYE GARDINER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY KAYE HOPFENBECK DNP

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 04/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 E 4800 S STE 230
MURRAY UT
84107-5535
US

IV. Provider business mailing address

2795 W 2850 S # A
SYRACUSE UT
84075-8205
US

V. Phone/Fax

Practice location:
  • Phone: 801-716-7008
  • Fax:
Mailing address:
  • Phone: 801-569-1976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number7657089-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: