Provider Demographics
NPI:1750070546
Name:HOSKISSON, BRIAN (APRN, PMHNP-BC, BSN)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:HOSKISSON
Suffix:
Gender:M
Credentials:APRN, PMHNP-BC, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 LOOP TRL
Mailing Address - Street 2:
Mailing Address - City:DUTCH JOHN
Mailing Address - State:UT
Mailing Address - Zip Code:84023-9718
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4516 S 700 E STE 370
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-8317
Practice Address - Country:US
Practice Address - Phone:801-597-4408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7986793-4405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health