Holly Jackson

NPI 1083882278 - Licensed Practical Nurse - 164W00000X

NPI Details
NPI 1083882278
Gender Female
Enumeration Date 02/11/2008
Last Updated 02/11/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
2040 MURRAY HOLLADAY RD STE 205
SALT LAKE CITY UT, 84117-5197, US
Phone (801) 274-0299
Fax
Business Location
2422 COBBLESTONE WAY
SANDY UT, 84093-1884, US
Phone
Fax
Toxanomy
Taxonomy Code 164W00000X
License State Utah
License Number 6683403-3101
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According to our database, Holly Jackson NPI is 1083882278, taxonomy code is 164W00000X and license number is 6683403-3101, license state is located at Utah. Holly Jackson physically located at 2040 Murray Holladay Rd Ste 205, Salt Lake City UT, 84117-5197. NPI Number Holly Jackson has the Individual type.

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1083882278 NPI number is provided on an as is basis without warranty of any kind. 1083882278 is maintained by the National Plan & Provider Enumeration System. The contents of Holly Jackson are for informational purposes only.