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General NPI Number Information
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NPI Number | 1083309645
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Entity Type | Individual
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Provider Name | JESSICA ANN FRAUGHTON FNP
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Gender | Female
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 170 N 1100 E
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City | AMERICAN FORK
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State | UT
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Zip | 84003-2096
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Country | US
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Telephone | 801-855-3337
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Fax |
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Provider Business Mailing Address
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Address Line | 770 E 1530 S
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City | LEHI
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State | UT
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Zip | 84043-5509
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Country | US
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Telephone | 801-874-5659
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10648526-8900
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 10648526-4405
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 10648526-3102
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License Number State | UT
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