Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 11725263-3400 | UT |
NPI | 1174144927 |
---|---|
Provider Name | Brianna Hudson |
First Address | Salt Lake City, UT 84117-5724 |
Second Address | Salt Lake City, UT 84117-5735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2020 |
Last Update Date | 04/05/2020 |