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General NPI Number Information
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NPI Number | 1396695672
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Entity Type | Individual
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Provider Name | ANDREA W JONES PBP
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Gender | Female
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 1884 E SHADOW DR 1884 E. SHADOW DR.
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City | EAGLE MOUNTAIN
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State | UT
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Zip | 84005-4792
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Country | US
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Telephone | 801-636-3932
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Fax |
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Provider Business Mailing Address
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Address Line | 1884 E SHADOW DR 1884 E. SHADOW DR.
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City | EAGLE MOUNTAIN
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State | UT
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Zip | 84005-4792
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Country | US
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Telephone | 801-636-3932
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 58-47B-304-1-O-I-D
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License Number State | UT
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