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1154376077
VICKI L JACKMAN
SALT LAKE CITY, UT
NPI
1154376077
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: UT 295232-4405)
Enumeration Date
2006-05-23
Last Update Date
2021-10-21
Business Address
VICKI L JACKMAN APRN
4624 HOLLADAY BLVD
SALT LAKE CITY, UT 84117-5206
Phone number: 801-277-2682
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Mailing Address
VICKI L JACKMAN APRN
4624 HOLLADAY BLVD
SALT LAKE CITY, UT 84117-5206
Phone number: 801-277-2682
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