Healthcare Provider Details

I. General information

NPI: 1902488844
Provider Name (Legal Business Name): MRS. JOLYNN GARFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 08/17/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 N 300 W STE 401
PROVO UT
84604-3306
US

IV. Provider business mailing address

1840 S 1300 E
SALT LAKE CITY UT
84105-3617
US

V. Phone/Fax

Practice location:
  • Phone: 801-357-7499
  • Fax: 801-373-5980
Mailing address:
  • Phone: 801-832-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9772467-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: