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Elizabeth J Avery, PA

Physician Assistant in Provo, UT. Individual provider (NPI-1).

NPI number1134828965
StatusActive
Last updated in NPPESSep 17, 2025

Details

NPI
1134828965
Entity type
Individual (NPI-1)
Name
Elizabeth J Avery
Credential
PA
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 1, 2023
Certification date
Sep 17, 2025
Last updated
Sep 17, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant14240564-1206UTYes

Other names

  • Elizabeth J Markle (Former Name)

Practice location

1055 N 500 W
Ste 205, Building C
Provo, UT 84604-3305

Phone 801-429-8095 · Fax 801-354-8265

Mailing address

1055 N 500 W
Att: Credentialing
Provo, UT 84604-3305

Phone 801-354-8226 · Fax 801-418-0941

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