Provider Demographics
NPI:1720401755
Name:STOKES, BRIAN MICHAEL (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:MICHAEL
Last Name:STOKES
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 E 4500 S
Mailing Address - Street 2:
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-2931
Mailing Address - Country:US
Mailing Address - Phone:801-648-4166
Mailing Address - Fax:
Practice Address - Street 1:392 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:UT
Practice Address - Zip Code:84014-1819
Practice Address - Country:US
Practice Address - Phone:801-577-8678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8027915-3102163W00000X
UT8027915-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse