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General NPI Number Information
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NPI Number | 1316851785
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Entity Type | Organization
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Legal Business Name | MEADOWBROOK FAMILY PRACTICE, PLLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 7030 W 2000 N
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City | MENDON
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State | UT
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Zip | 84325-9798
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Country | US
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Telephone | 435-317-5348
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Fax | 435-252-0791
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Provider Business Mailing Address
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Address Line | 701 S MAIN ST STE 114
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City | LOGAN
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State | UT
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Zip | 84321-5765
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Country | US
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Telephone | 435-317-5348
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Fax | 435-252-0791
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BROOKE TUTTLE
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Credential | FNP-C
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Telephone | 801-671-5738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | NULL
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