Healthcare Provider Details

I. General information

NPI: 1316354616
Provider Name (Legal Business Name): SUSANNE FRANCES JONES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2014
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 E WILSON AVE
SALT LAKE CITY UT
84115-1935
US

IV. Provider business mailing address

PO BOX 307
BOUNTIFUL UT
84011-0307
US

V. Phone/Fax

Practice location:
  • Phone: 801-943-3300
  • Fax: 801-294-6917
Mailing address:
  • Phone: 801-294-6907
  • Fax: 801-294-6917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7077165-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: