Breanna F Upstill, PHARMD

Individual provider Active NPI Pharmacist · Mapleton, UT

NPI 1093301749 · NPPES record last updated Dec 16, 2020

Key facts

NPI
1093301749
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
7792652-1701 (UT)
Practice address
724 S 1600 W
Mapleton, UT 84664-4347
Phone
(801) 515-6048
NPI assigned
Dec 16, 2020
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
7792652-1701UTMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7792652-1701 UT Yes

Addresses

Primary practice location

724 S 1600 W
Mapleton, UT 84664-4347

Mailing address

724 S 1600 W
Mapleton, UT 84664-4347
Phone (801) 515-6048

Other providers in Mapleton, UT

All providers in Mapleton, UT · Pharmacist in Utah

Sources for this page

Verify at the official NPI Registry.