Provider Demographics
NPI:1467861849
Name:PRZYBYLA, TANYA BIDSTRUP (PA-C)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:BIDSTRUP
Last Name:PRZYBYLA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 N 1100 E
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2054
Mailing Address - Country:US
Mailing Address - Phone:801-855-3841
Mailing Address - Fax:
Practice Address - Street 1:226 N 1100 E
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2054
Practice Address - Country:US
Practice Address - Phone:801-855-3841
Practice Address - Fax:801-855-3847
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant