Healthcare Provider Details

I. General information

NPI: 1972436178
Provider Name (Legal Business Name): JILL ERIN NORMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 S MAIN ST
SALT LAKE CITY UT
84101-3468
US

IV. Provider business mailing address

12391 S 4000 W
RIVERTON UT
84096-7012
US

V. Phone/Fax

Practice location:
  • Phone: 801-835-4236
  • Fax:
Mailing address:
  • Phone: 801-302-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number12482488-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: