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

Brynna Haddock, FNP-C

Individual provider Family Medicine Physician · NPI 1104622158

Brynna Haddock, FNP-C is a Nurse Practitioner in Provo, Utah. Qualified in 2024, 2 years ago. Offers telehealth. Licensed in Utah.

Years since qualifying
2
Licensed in
UT
In the registry since
2025
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

1055 N 500 W Ste 222
Provo, UT 84604-3305
Phone: (801) 354-8225
Fax: (801) 418-0941
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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 14205405-4405 (UT)
Family Medicine Physician Taxonomy 207Q00000X · Licence 14205405-4405 (UT)

Record details

NPI number1104622158
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedFebruary 20, 2025
Last updated in NPPESMarch 7, 2025
Certification dateMarch 7, 2025
Mailing address1055 N 500 W, Attn: Credentialing, Provo, UT 84604-3305

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
TelehealthOffers telehealth services

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