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NPI Code Detail

MEDICARE: JENNIE MARIA OSHEA C.C.P.

MEDICARE:   JENNIE MARIA OSHEA  C.C.P.
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
1242T00000XPerfusionist

General Provider Information

NPI Number : 1538354287
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIE MARIA OSHEA C.C.P.
Provider Business Mailing Address
First Line : 2555 S 400 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-3305
Country : US
Telephone Number : 801-401-8922
Fax Number :
Provider Business Practice Location Address
First Line : 2555 S 400 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84115-3305
Country : US
Telephone Number : 801-401-8922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2007
Last Update Date : 09/06/2007

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Directions to “ JENNIE MARIA OSHEA C.C.P.” Practice Location

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