DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: VICKI L JACKMAN APRN

MEDICARE: VICKI L JACKMAN APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner295232-4405UT

General Provider Information

NPI Number : 1154376077
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI L JACKMAN APRN
Provider Business Mailing Address
First Line : 4624 HOLLADAY BLVD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-5206
Country : US
Telephone Number : 801-277-2682
Fax Number : 801-277-2980
Provider Business Practice Location Address
First Line : 4624 HOLLADAY BLVD
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-5206
Country : US
Telephone Number : 801-277-2682
Fax Number : 801-277-2980
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 10/21/2021

Similar Medicare Providers

1508810508 — OLYMPUS CLINIC
Practice Location Address:
4624 HOLLADAY BLVD
SALT LAKE CITY, UT
84117-5206
Practice Phone: 801-277-2682
Practice Fax: 801-277-2980
1366497166 — STEVEN W HEATH MD
Practice Location Address:
4624 HOLLADAY BLVD
SALT LAKE CITY, UT
84117-5206
Practice Phone: 801-277-2682
Practice Fax: 801-277-2980
1487609277 — CHRISTOPHER J GAMBLE MD
Practice Location Address:
4624 HOLLADAY BLVD
SALT LAKE CITY, UT
84117-5206
Practice Phone: 801-277-2682
Practice Fax: 801-277-2980
1346295177 — JARED B PROBST MD
Practice Location Address:
4624 HOLLADAY BLVD
SALT LAKE CITY, UT
84117-5206
Practice Phone: 801-277-2682
Practice Fax: 801-277-2980
1528006491 — DR. JON T WALL MD
Practice Location Address:
4624 HOLLADAY BLVD
SALT LAKE CITY, UT
84117-5206
Practice Phone: 801-277-2682
Practice Fax: 801-277-2980
1770521643 — DR. ROBERT J HILL JR. MD
Practice Location Address:
4624 HOLLADAY BLVD
SALT LAKE CITY, UT
84117-5206
Practice Phone: 801-277-2682
Practice Fax: 801-277-2980

Directions to “ VICKI L JACKMAN APRN” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.