Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Staci Janae Brandenburg, PA-C

Individual provider Physician Assistant · NPI 1487279626

Staci Janae Brandenburg, PA-C is a Physician Assistant in West Valley City, Utah. Works from 2 locations. Licensed in Utah.

Licensed in
UT
In the registry since
2020
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2965 W 3500 S
West Valley City, UT 84119-3602
Phone: (801) 965-3419
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6749 S Sienna Park Ln, Midvale, UT 84047-5036 — (435) 238-0202

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 12602904-8906 (UT)
Physician Assistant Taxonomy 363A00000X · Licence 12602904-8906 (UT)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (UT)

Record details

NPI number1487279626
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 13, 2020
Last updated in NPPESOctober 14, 2024
Certification dateOctober 14, 2024

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