Individual provider · Type 1 NPI

Brynna Haddock, FNP-C

Nurse Practitioner · Provo, UT

NPI number 1104622158 Active

Practice location

1055 N 500 W Ste 222
Provo, UT 84604-3305

Call (801) 354-8225 Map

Fax (801) 418-0941

Mailing address

1055 N 500 W, Attn: Credentialing
Provo, UT 84604-3305

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000X14205405-4405 (UT)
Nurse Practitioner Primary 363L00000X14205405-4405 (UT)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1104622158

Brynna Haddock, FNP-C's National Provider Identifier is 1104622158, issued on Feb 20, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Provo, UT. The record was last updated on Mar 7, 2025.