MEDICARE: ANDREW WINN BRINGHURST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	9385227-1206	UT

General Provider Information

NPI Number	:	1215553151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW WINN BRINGHURST

Provider Business Mailing Address
First Line	:	10433 S REDWOOD RD
Second Line	:
City	:	SOUTH JORDAN
State	:	UT
Zip	:	84095-8502
Country	:	US
Telephone Number	:	801-260-1919
Fax Number	:

Provider Business Practice Location Address
First Line	:	3934 S 2300 E
Second Line	:
City	:	HOLLADAY
State	:	UT
Zip	:	84124-2848
Country	:	US
Telephone Number	:	801-849-8500
Fax Number	:	801-849-8502

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2020
Last Update Date	:	12/10/2025

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