Healthcare Provider Details

I. General information

NPI: 1871251926
Provider Name (Legal Business Name): JAYANDRA STARNER FNP-C, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2021
Last Update Date: 04/24/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 S 900 E STE 240
MURRAY UT
84117-7210
US

IV. Provider business mailing address

5505 S 900 E STE 240
MURRAY UT
84117-7210
US

V. Phone/Fax

Practice location:
  • Phone: 801-783-5011
  • Fax:
Mailing address:
  • Phone: 801-783-5011
  • Fax: 904-240-4468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number13519115-8900
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number13519115-4405
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number13519115-8900
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: