Individual
BRETT LAVAR CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.P.R.N.
Contact information
Practice address
8TH AVE C ST, SALT LAKE CITY, UT 84143-0001
(801) 408-3729
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
292953-4405
UT
363LA2100X
Acute Care Nurse Practitioner
292953-4405
UT
Other
Enumeration date
09/12/2016
Last updated
11/19/2025
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