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NPI Code Detail

MEDICARE: JAMIELYN EKIKO GIBSON

MEDICARE: JAMIELYN EKIKO GIBSON
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
1171M00000XCase Manager/Care CoordinatorUT

General Provider Information

NPI Number : 1467149914
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIELYN EKIKO GIBSON
Provider Business Mailing Address
First Line : 90 E 200 N
Second Line :
City : LOGAN
State : UT
Zip : 84321-4034
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 90 E 200 N
Second Line :
City : LOGAN
State : UT
Zip : 84321-4034
Country : US
Telephone Number : 435-752-0750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2023
Last Update Date : 04/21/2026

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Directions to “ JAMIELYN EKIKO GIBSON ” 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.

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