MEDICARE: MARISSA JARRETT DNP

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	8409942-4405	UT

General Provider Information

NPI Number	:	1538782081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA JARRETT DNP

Provider Business Mailing Address
First Line	:	3556 PIUTE DR
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84604-4806
Country	:	US
Telephone Number	:	801-450-3686
Fax Number	:

Provider Business Practice Location Address
First Line	:	5770 S 250 E STE 300
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84107-8110
Country	:	US
Telephone Number	:	801-314-2500
Fax Number	:

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

Provider Enumeration Date	:	05/19/2020
Last Update Date	:	03/17/2024

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