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NPI 1407746993

NPI 1407746993 : MACY ANNA BRYANT : LOGAN, UT

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General NPI Number Information
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    NPI Number           |    1407746993
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    Entity Type          |    Individual 
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    Provider Name        |    MACY ANNA BRYANT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/07/2025
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    Last Update Date     |    07/07/2025
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Provider Practice Location Address
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    Address Line         |    209 E 870 N 
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    City                 |    LOGAN
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    State                |    UT
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    Zip                  |    84321-3333
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    Country              |    US
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    Telephone            |    801-550-3178
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7533 S CENTER VIEW CT STE N 
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    City                 |    WEST JORDAN
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    State                |    UT
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    Zip                  |    84084-5526
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    133NN1002X
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    Taxonomy Name        |    Nutrition Education Nutritionist
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    License Number       |    
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    License Number State |    
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