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General NPI Number Information
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NPI Number | 1841970662
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Entity Type | Individual
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Provider Name | MCCALL JEWETT NP
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Gender | Female
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Dates
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Enumeration Date | 07/18/2023
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 555 W SR 164
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City | SALEM
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State | UT
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Zip | 84653
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Country | US
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Telephone | 801-465-4896
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Fax | 801-465-0606
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Provider Business Mailing Address
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Address Line | PO BOX 30079
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City | SALT LAKE CITY
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State | UT
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Zip | 84130-0079
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Country | US
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Telephone | 801-375-8858
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Fax | 801-429-8180
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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 | 8339669-4405
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License Number State | UT
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