Brandenburg, Staci Janae

Brandenburg, Staci Janae is an individual health care provider with primary practice located at 2965 W 3500 S , West Valley City UT 84119-3602. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Brandenburg, Staci Janae can be contacted via phone (801) 965-3419.

Contact Information

Primary practice address
2965 W 3500 S West Valley City UT 84119-3602
Phone: (801) 965-3419
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 12602904-8906 Utah
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X Utah
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 12602904-8906 Utah

Profile Details

NPI number 1487279626
LBN Legal business name Brandenburg, Staci Janae
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2020
Last updated Oct 14th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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