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General NPI Number Information
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NPI Number | 1861357725
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Entity Type | Individual
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Provider Name | JESSICA EMMA ANTUNEZ RN,BSN
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Gender | Female
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 266 S LEFT FORK HOBBLE CREEK CYN
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City | SPRINGVILLE
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State | UT
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Zip | 84663-6165
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Country | US
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Telephone | 801-358-6675
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Fax | 801-358-6675
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Provider Business Mailing Address
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Address Line | 1457 E 1540 S
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City | SPANISH FORK
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State | UT
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Zip | 84660-3512
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Country | US
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Telephone | 801-358-6675
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Fax | 801-358-6675
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 1264991-3102
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License Number State | UT
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