Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brandon D Park, APRN

Individual provider Nurse Practitioner · NPI 1811960123

Brandon D Park, APRN is a Nurse Practitioner in Ogden, Utah. Qualified in 2004, 22 years ago. Practices with Ogden Clinic Specialty Services LLC, a 133-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
22
Licensed in
UT
In the registry since
2006
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

4700 Harrison Blvd
Ogden, UT 84403-4303
Phone: (801) 475-3300
Fax: (801) 475-3301
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 3749704405 (UT)

Record details

NPI number1811960123
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN
Sole proprietorNo
NPI enumeratedFebruary 8, 2006
Last updated in NPPESOctober 25, 2024
Certification dateOctober 25, 2024
Mailing addressPo Box 5546, Denver, CO 80217-5546

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Ogden Clinic Specialty Services Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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