Organization
ANEW CLINICAL PRACTITIONERS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA LYNN BROADHEAD (DNP)
(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
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/16/2020
Last updated
11/04/2020
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