Healthcare Provider Details

I. General information

NPI: 1831841535
Provider Name (Legal Business Name): WESTBROEK FAMILY MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 40TH ST STE 111
OGDEN UT
84403-1856
US

IV. Provider business mailing address

434 W ASCENSION WAY STE 425
MURRAY UT
84123-3102
US

V. Phone/Fax

Practice location:
  • Phone: 801-515-7997
  • Fax: 385-333-7413
Mailing address:
  • Phone: 801-515-7997
  • Fax: 385-333-7413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RYAN LEE WESTBROEK
Title or Position: OWNER
Credential: FNP
Phone: 801-529-8935