| Doctor Name: | JAN CLEMENTS |
| NPI Number: | 1124449285 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN |
| License Number: | 193894-4405 |
| Business Practice Address: | 789 Bamberger Dr Suite B American Fork, UT - 840032181 |
| Business Phone Number: | 8015997848 |
| Business Fax Number: | |
| Mailing Address: | 1605 E Shadow Cv, COTTONWOOD HEIGHTS |
| State: | UT |
| Postal Code: | 841213664 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/16/2013 |
| NPI Last Update Date: | 04/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 193894-4405 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |