Individual
SAMANTHA GAJKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, AGNP-C
Contact information
Practice address
555 FOOTHILL DR, SALT LAKE CITY, UT 84112-1106
(801) 581-2628
Mailing address
555 FOOTHILL DR, SALT LAKE CITY, UT 84112-1106
(801) 581-2628
(801) 585-2293
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.453580
OH
363LG0600X
Gerontology Nurse Practitioner
Primary
13475405-4405
UT
363LP2300X
Primary Care Nurse Practitioner
13475405-4405
UT
Other
Enumeration date
03/21/2023
Last updated
03/09/2026
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