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MR. BRADEN WILSON WOLTHUIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ACNP

Contact information

Practice address
4401 HARRISON BOULEVARD, OGDEN, UT 84403
(801) 387-2371
Mailing address
4401 HARRISON BOULEVARD, MCKAY-DEE HOSPITAL ACUTE PAIN SERVICE, OGDEN, UT 84403
(801) 387-2371

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
8055787-3102
UT
363LA2100X
Acute Care Nurse Practitioner
Primary
8055787-4405
UT

Other

Enumeration date
02/24/2012
Last updated
06/18/2019
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