Organization
ANEW CLINICAL PRACTITIONERS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA LYNN BROADHEAD DNP, APRN, FNP-BC (OWNER/MEDICAL DIRECTOR)
(801) 654-3229
Entity
Organization
Contact information
Practice address
11762 S STATE ST STE 160, DRAPER, UT 84020-7174
(801) 654-3229
Mailing address
11762 S STATE ST STE 160, DRAPER, UT 84020-7174
(801) 654-3229
(949) 404-6797
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/11/2018
Last updated
06/17/2020
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