=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497633341
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER LITTRELL FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/26/2025
-----------------------------------------------------
Last Update Date | 10/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5285 S 400 E STE B
-----------------------------------------------------
City | WASHINGTON TERRACE
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84405-7194
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-779-3500
-----------------------------------------------------
Fax | 801-779-3508
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3702 S STATE ST STE 107
-----------------------------------------------------
City | SOUTH SALT LAKE
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84115-5096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-288-2634
-----------------------------------------------------
Fax | 801-288-1186
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 308811-4405
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------