Provider Demographics
NPI:1558955211
Name:BYINGTON, HAILI BREANN (PA-C)
Entity Type:Individual
Prefix:
First Name:HAILI
Middle Name:BREANN
Last Name:BYINGTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HAILI
Other - Middle Name:BREANN
Other - Last Name:COFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:801-285-4600
Mailing Address - Fax:
Practice Address - Street 1:3723 W 12600 S STE 270
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84065-7296
Practice Address - Country:US
Practice Address - Phone:801-285-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12505249-1206363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical