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

Breanna Bradley Black, PA-C

Individual provider Physician Assistant · NPI 1346972502

Breanna Bradley Black, PA-C is a Physician Assistant in Provo, Utah. Licensed in Utah. Registered with an NPI since 2022.

Licensed in
UT
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

1055 N 500 W Bldg A
Provo, UT 84604-3305
Phone: (801) 812-5033
Fax: (801) 418-0941
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 13603008-1206 (UT)

Record details

NPI number1346972502
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 27, 2022
Last updated in NPPESOctober 3, 2023
Certification dateOctober 3, 2023

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