NPI 1164971560

Amanda Madrid, PAC

Practitioner Physician Assistant Stansbury Park, UT

Practice location

Address: 220 Millpond, Stansbury Park, UT 84074-9745
Phone: (435) 843-3096
Mailing address: 1603 W Brigadoon Park Dr, West Jordan, UT 84088-6598

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 10097228-1206 (UT)

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Registry record

NPI: 1164971560
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Sep 2016
Record last updated: 18 Nov 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.