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NPI Code Detail

MEDICARE: JACIE K STEED

MEDICARE: JACIE K STEED
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 Coordinator

General Provider Information

NPI Number : 1871220517
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACIE K STEED
Provider Business Mailing Address
First Line : 4825 W 20400 N
Second Line :
City : PLYMOUTH
State : UT
Zip : 84330-7721
Country : US
Telephone Number : 435-230-2380
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 : 08/03/2022
Last Update Date : 08/03/2022

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Directions to “ JACIE K STEED ” Practice Location

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