MEDICARE: RACHEL JENKINS-LLOYD APRN, PMHNP-BC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	353873-4405	UT

General Provider Information

NPI Number	:	1205237799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL JENKINS-LLOYD APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	8784 S IDA LN
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84093-1419
Country	:	US
Telephone Number	:	801-598-7565
Fax Number	:	844-296-5481

Provider Business Practice Location Address
First Line	:	1972 W 5400 S
Second Line	:
City	:	TAYLORSVILLE
State	:	UT
Zip	:	84129-1459
Country	:	US
Telephone Number	:	801-598-7565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2014
Last Update Date	:	05/21/2020

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