# JAN CLEMENTS AGNP CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124434501
- **Authorized official:** MS. JAN CLEMENTS N.P. (NURSE PRACTIONER)
- **Authorized official phone:** (801) 796-7961

## Contact information

- **Practice address:** 66 E STATE RD, PLEASANT GROVE, UT 84062-2637
- **Practice address phone:** (801) 796-7961
- **Practice address fax:** (801) 796-1101
- **Mailing address:** 66 E STATE RD, PLEASANT GROVE, UT 84062-2637
- **Mailing address phone:** (801) 796-7961
- **Mailing address fax:** (801) 796-1101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | 1938944405 | UT | Yes |

## Other

- **Enumeration date:** 07/07/2014
- **Last updated:** 07/07/2014