Provider Demographics
NPI:1912427139
Name:GARDINER, BRITTANY KAYE
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:KAYE
Last Name:GARDINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:KAYE
Other - Last Name:HOPFENBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:2795 W 2850 S
Mailing Address - Street 2:# A
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-8205
Mailing Address - Country:US
Mailing Address - Phone:801-569-1976
Mailing Address - Fax:
Practice Address - Street 1:835 E 4800 S
Practice Address - Street 2:STE 230
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-5535
Practice Address - Country:US
Practice Address - Phone:801-716-7008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7657089-4405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner