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General NPI Number Information
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NPI Number | 1679975700
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Entity Type | Individual
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Provider Name | JILLIAN LOZANOFF APRN, FNP
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Gender | Female
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 880 HERITAGE PARK BLVD STE 130
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City | LAYTON
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State | UT
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Zip | 84041-5674
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Country | US
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Telephone | 801-335-4114
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Fax | 833-569-5678
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Provider Business Mailing Address
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Address Line | 880 HERITAGE PARK BLVD STE 130
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City | LAYTON
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State | UT
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Zip | 84041-5674
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Country | US
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Telephone | 801-335-4114
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Fax | 833-569-5678
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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 | 10376636-4405
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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 | AP60497304
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License Number State | WA
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