# ANEW CLINICAL PRACTITIONERS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689145963
- **Authorized official:** TAMARA LYNN BROADHEAD DNP, APRN, FNP-BC (OWNER/MEDICAL DIRECTOR)
- **Authorized official phone:** (801) 654-3229

## Contact information

- **Practice address:** 11762 S STATE ST STE 160, DRAPER, UT 84020-7174
- **Practice address phone:** (801) 654-3229
- **Mailing address:** 11762 S STATE ST STE 160, DRAPER, UT 84020-7174
- **Mailing address phone:** (801) 654-3229
- **Mailing address fax:** (949) 404-6797

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2018
- **Last updated:** 06/17/2020