Healthcare Provider Details

I. General information

NPI: 1912695388
Provider Name (Legal Business Name): JENNIFER BRIMHALL RIGBY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 N 500 W BLDG A
PROVO UT
84604-3305
US

IV. Provider business mailing address

2530 W HANCOCK ST
MAPLETON UT
84664-4374
US

V. Phone/Fax

Practice location:
  • Phone: 801-812-5033
  • Fax: 801-812-5034
Mailing address:
  • Phone: 801-599-0115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number6911025-3102
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6911025-8900
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: