Provider Demographics
NPI:1245269414
Name:O'BRYANT, CATHERINE J (CPM LDEM)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:J
Last Name:O'BRYANT
Suffix:
Gender:F
Credentials:CPM LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 S 300 E
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-2519
Mailing Address - Country:US
Mailing Address - Phone:801-465-4021
Mailing Address - Fax:
Practice Address - Street 1:593 S 300 E
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-2519
Practice Address - Country:US
Practice Address - Phone:801-465-4021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6132354-3400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife