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General NPI Number Information
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NPI Number | 1386399467
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Entity Type | Individual
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Provider Name | JORDYN CHANDLER
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Gender | Female
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Dates
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Enumeration Date | 02/16/2022
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 1868 N 1200 W
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City | LAYTON
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State | UT
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Zip | 84041-1939
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Country | US
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Telephone | 801-614-9030
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Fax | 801-614-9040
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Provider Business Mailing Address
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Address Line | 3942 S 3450 W
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City | WEST HAVEN
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State | UT
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Zip | 84401-2094
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Country | US
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Telephone | 801-391-3841
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 12642400-1206
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License Number State | UT
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