Provider Demographics
NPI:1477078681
Name:BITTER, FARA (CD, CPM, LDEM)
Entity type:Individual
Prefix:MRS
First Name:FARA
Middle Name:
Last Name:BITTER
Suffix:
Gender:F
Credentials:CD, CPM, LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4339 S 175 E
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON TERRACE
Mailing Address - State:UT
Mailing Address - Zip Code:84405-5622
Mailing Address - Country:US
Mailing Address - Phone:801-710-3998
Mailing Address - Fax:
Practice Address - Street 1:2562 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-3103
Practice Address - Country:US
Practice Address - Phone:801-710-3998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-08
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT342745-3400176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty