Active NPI
Brooke Etherington, P.A.
- Medical Physician Assistant
- Millcreek, UT
National Provider Identifier
1104009737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 342203-8906
- Practice address
- 3300 E Millcreek Canyon Rd
Millcreek, UT 84109-4104 - Phone
- (801) 633-6268
- NPI assigned
- Dec 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 342203-8906 | UT | Primary |
Addresses
Primary practice location
3300 E Millcreek Canyon Rd
Millcreek, UT 84109-4104
Mailing address
3300 E Millcreek Canyon Rd
Millcreek, UT 84109-4104
Phone (801) 633-6268
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 342203-8906 | UT | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772668800000",
"number": "1104009737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 E MILLCREEK CANYON RD",
"city": "MILLCREEK",
"state": "UT",
"postal_code": "841094104",
"telephone_number": "801-633-6268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 E MILLCREEK CANYON RD",
"city": "MILLCREEK",
"state": "UT",
"postal_code": "841094104",
"telephone_number": "801-633-6268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETHERINGTON",
"first_name": "BROOKE",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-05",
"last_updated": "2026-03-05",
"certification_date": "2026-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "UT",
"license": "342203-8906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Millcreek, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.