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Breanna Black, PA-C
NPI 1346972502 · on the registry since 2022
Practice
- Address
- 1055 N 500 W Bldg A
Provo, UT 84604 - Phone
- (801) 812-5033
- Fax
- (801) 418-0941
- Organisation at this address
- Revere Health Pc
Revere Health Pc
Total Renal Care Inc
Total Renal Care Inc
Central Utah Clinic, P.C.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 235
Registry record
- Primary taxonomy
- Physician Assistant
363A00000X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-10-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah