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NPI Code Detail

MEDICARE: ASHLEY BROOKE JAMSA PA-S

MEDICARE: ASHLEY BROOKE JAMSA PA-S
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
1363AM0700XMedical Physician Assistant14245507-1206UT
2363A00000XPhysician Assistant14245507-1206UT

General Provider Information

NPI Number : 1932957032
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY BROOKE JAMSA PA-S
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5171 S COTTONWOOD ST STE 210
Second Line :
City : MURRAY
State : UT
Zip : 84107-5718
Country : US
Telephone Number : 801-507-3380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2024
Last Update Date : 06/03/2026

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