Healthcare Provider Details

I. General information

NPI: 1982179735
Provider Name (Legal Business Name): JEREMIE GARCIA SCHARNKE MSN, APRN, AGNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JEREMIE VELASCO GARCIA

II. Dates (important events)

Enumeration Date: 10/08/2018
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 NORTH MARIO CAPECCHI DRIVE ROOM 4N155
SALT LAKE CITY UT
84113
US

IV. Provider business mailing address

4905 N VIALETTO WAY
LEHI UT
84043-4869
US

V. Phone/Fax

Practice location:
  • Phone: 435-830-9123
  • Fax:
Mailing address:
  • Phone: 347-713-2887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number13861815-4405
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberF308631-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number13861815-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: