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General NPI Number Information
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NPI Number | 1467376434
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Entity Type | Individual
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Provider Name | JESSICA PRINCE
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Gender | Female
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 8135 S 805 E
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City | SANDY
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State | UT
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Zip | 84094-0630
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Country | US
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Telephone | 480-307-2122
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Fax |
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Provider Business Mailing Address
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Address Line | 8135 S 805 E
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City | SANDY
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State | UT
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Zip | 84094-0630
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Country | US
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Telephone |
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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 | 12637951-4405
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License Number State | UT
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