Individual provider · Type 1 NPI

Breanna Bradley Black, PA-C

Physician Assistant · Provo, UT

NPI number 1346972502 Active

Practice location

1055 N 500 W Bldg A
Provo, UT 84604-3305

Call (801) 812-5033 Map

Fax (801) 418-0941

Mailing address

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

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X13603008-1206 (UT)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1346972502

Breanna Bradley Black, PA-C's National Provider Identifier is 1346972502, issued on Jun 27, 2022. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Provo, UT. The record was last updated on Oct 3, 2023.