Provider Demographics
NPI:1730429374
Name:BRYANT, PAULA HUFF (PA-C, RD)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:HUFF
Last Name:BRYANT
Suffix:
Gender:F
Credentials:PA-C, RD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1055 N 500 W
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3305
Mailing Address - Country:US
Mailing Address - Phone:801-354-8225
Mailing Address - Fax:801-418-0941
Practice Address - Street 1:3570 W 9000 S
Practice Address - Street 2:STE. 200
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-8869
Practice Address - Country:US
Practice Address - Phone:801-566-9211
Practice Address - Fax:801-566-5667
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT6894386-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant