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NPI Code Detail

MEDICARE: MS. JACQUELYNNE LAREEN CHLARSON

MEDICARE:  MS. JACQUELYNNE LAREEN CHLARSON
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
1372500000XChore Provider
2372600000XAdult Companion
3376J00000XHomemaker

General Provider Information

NPI Number : 1922315407
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JACQUELYNNE LAREEN CHLARSON
Provider Business Mailing Address
First Line : P.O. BOX 344
Second Line :
City : MAGNA
State : UT
Zip : 84044-0344
Country : US
Telephone Number : 801-250-4436
Fax Number :
Provider Business Practice Location Address
First Line : 7302 WEST 3500 SOUTH
Second Line :
City : MAGNA
State : UT
Zip : 84044-2449
Country : US
Telephone Number : 801-250-4436
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2010
Last Update Date : 09/07/2010

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Directions to “ MS. JACQUELYNNE LAREEN CHLARSON ” Practice Location

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