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NPI Code Detail

MEDICARE: JILLIAN LOZANOFF APRN, FNP

MEDICARE: JILLIAN LOZANOFF APRN, FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner10376636-4405UT
2363LF0000XFamily Nurse PractitionerAP60497304WA

General Provider Information

NPI Number : 1679975700
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILLIAN LOZANOFF APRN, FNP
Provider Business Mailing Address
First Line : 880 HERITAGE PARK BLVD STE 130
Second Line :
City : LAYTON
State : UT
Zip : 84041-5674
Country : US
Telephone Number : 801-335-4114
Fax Number : 833-569-5678
Provider Business Practice Location Address
First Line : 880 HERITAGE PARK BLVD STE 130
Second Line :
City : LAYTON
State : UT
Zip : 84041-5674
Country : US
Telephone Number : 801-335-4114
Fax Number : 833-569-5678
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2014
Last Update Date : 07/21/2022

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