Doctor Name: | KATHERINE JENKINS |
NPI Number: | 1972907541 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 5588977-4405 |
Business Practice Address: | 667 Canterbury Ln North Salt Lake, UT - 840546092 |
Business Phone Number: | 8015507465 |
Business Fax Number: | |
Mailing Address: | 667 Canterbury Ln, NORTH SALT LAKE |
State: | UT |
Postal Code: | 840546092 |
Phone Number: | 8015507465 |
Fax Number: | |
NPI Enumeration Date: | 10/10/2014 |
NPI Last Update Date: | 10/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 5588977-4405 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |