Healthcare Provider Details
I. General information
NPI: 1285329326
Provider Name (Legal Business Name): BRIANA EWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/05/2023
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
443 S 600 E
SALT LAKE CITY UT
84102-2708
US
IV. Provider business mailing address
4460 S HIGHLAND DR STE 120
SALT LAKE CITY UT
84124-3550
US
V. Phone/Fax
- Phone: 888-949-4864
- Fax:
- Phone: 888-949-4864
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | F26-137554 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: