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General NPI Number Information
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NPI Number | 1033932975
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Entity Type | Individual
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Provider Name | NATALIE E ROYSTER-JENSEN PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 498 N KAYS DR STE 200
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City | KAYSVILLE
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State | UT
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Zip | 84037-4153
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Country | US
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Telephone | 385-382-1555
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Fax |
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Provider Business Mailing Address
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Address Line | 572 E 11TH AVE
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City | SALT LAKE CITY
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State | UT
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Zip | 84103-3205
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Country | US
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Telephone | 801-792-8175
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5893152-4405
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License Number State | UT
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