Individual
MIRANDA MARY BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(385) 405-6058
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11601751-3102
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/08/2025
Last updated
03/04/2026
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