Healthcare Provider Details

I. General information

NPI: 1063306017
Provider Name (Legal Business Name): CELIA NICOLE MARIE JOTTE BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 S 2000 E
SALT LAKE CITY UT
84112-5880
US

IV. Provider business mailing address

1828 S 1100 E APT 1
SALT LAKE CITY UT
84105-3462
US

V. Phone/Fax

Practice location:
  • Phone: 801-581-3414
  • Fax:
Mailing address:
  • Phone: 720-315-2173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number14082342-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: