Healthcare Provider Details

I. General information

NPI: 1891613964
Provider Name (Legal Business Name): JENNIE MCFARLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5184 RENDEZVOUS RD
MOUNTAIN GREEN UT
84050-9746
US

IV. Provider business mailing address

5184 RENDEZVOUS RD
MOUNTAIN GREEN UT
84050-9746
US

V. Phone/Fax

Practice location:
  • Phone: 336-404-3018
  • Fax:
Mailing address:
  • Phone: 336-404-3018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11401967-1701
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: