Healthcare Provider Details

I. General information

NPI: 1558108704
Provider Name (Legal Business Name): AMY M JONES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S STATE ST STE 2
CLEARFIELD UT
84015-1210
US

IV. Provider business mailing address

600 S STATE ST STE 2
CLEARFIELD UT
84015-1210
US

V. Phone/Fax

Practice location:
  • Phone: 385-483-1003
  • Fax: 801-797-0725
Mailing address:
  • Phone: 385-483-1003
  • Fax: 801-797-0725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5348483-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: