Provider Demographics
NPI:1306447362
Name:TAFOYA, BRANDY M (APRN-C)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:M
Last Name:TAFOYA
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1448 N 2000 W STE 3
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:UT
Mailing Address - Zip Code:84015-8388
Mailing Address - Country:US
Mailing Address - Phone:801-866-5353
Mailing Address - Fax:
Practice Address - Street 1:1448 N 2000 W STE 3
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:UT
Practice Address - Zip Code:84015-8388
Practice Address - Country:US
Practice Address - Phone:801-940-5542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3358364405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily