| Providential Bba Operating Lp | |
|
401 S 400 E Bountiful UT 84010-4933 | |
| (801) 397-8145 | |
| (201) 294-5877 |
| Full Name | Providential Bba Operating Lp |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 401 S 400 E, Bountiful, Utah |
| Authorized Official Name and Position | Michelle Brown (CFO) |
| Authorized Official Contact | 8013978145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providential Bba Operating Lp 481 S 400 E Bountiful UT 84010-4933 Ph: (801) 397-8145 | Providential Bba Operating Lp 401 S 400 E Bountiful UT 84010-4933 Ph: (801) 397-8145 |
| NPI Number | 1376325001 |
|---|---|
| Provider Enumeration Date | 10/17/2023 |
| Last Update Date | 10/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376325001 | NPI | - | NPPES |
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