Basic Information
Provider Information
NPI: 1871865071
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOVEDAY
FirstName: BRIGHTON
MiddleName: ARIEL
NamePrefix: MRS.
NameSuffix:  
Credential: ANP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 127 S 500 E STE 600
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841021971
CountryCode: US
TelephoneNumber: 8015876705
FaxNumber: 8017158228
Practice Location
Address1: 1950 CIRCLE OF HOPE
Address2: SOS CLINIC
City: SALT LAKE CITY
State: UT
PostalCode: 841125550
CountryCode: US
TelephoneNumber: 8015850100
FaxNumber: 8015817575
Other Information
ProviderEnumerationDate: 02/02/2012
LastUpdateDate: 11/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X224386-4405UTY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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