Provider Demographics
NPI:1275266009
Name:ABOVE AND BEYOND MOBILE HEALTHCARE PC
Entity Type:Organization
Organization Name:ABOVE AND BEYOND MOBILE HEALTHCARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOUCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-450-6081
Mailing Address - Street 1:801 E SILVER SAGE DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-4919
Mailing Address - Country:US
Mailing Address - Phone:801-450-6081
Mailing Address - Fax:
Practice Address - Street 1:801 E SILVER SAGE DR
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84094-4919
Practice Address - Country:US
Practice Address - Phone:801-450-6081
Practice Address - Fax:435-608-3274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2022-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty