Healthcare Provider Details

I. General information

NPI: 1508358193
Provider Name (Legal Business Name): ANNA MARIE MCMILLAN JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA MARIE MCMILLAN JONES FNP-C

II. Dates (important events)

Enumeration Date: 05/31/2018
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5155 LAMB DR
MORGAN UT
84050-9732
US

IV. Provider business mailing address

5155 LAMB DR
MORGAN UT
84050-9732
US

V. Phone/Fax

Practice location:
  • Phone: 801-829-8623
  • Fax: 385-469-5222
Mailing address:
  • Phone: 801-829-8623
  • Fax: 385-469-5222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6422451-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: