Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 12397467-1205 | UT |
N | 2080P0204X | Pediatric Emergency Doctor | MD450482 | PA |
NPI | 1134383086 |
---|---|
Provider Name | Dr. Brenda M Ritson |
First Address | Pleasant Grove, UT 84062-4104 |
Second Address | Pleasant Grove, UT 84062-4104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2008 |
Last Update Date | 09/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1028900860001 | (05) | PA |