Individual
DR. JENNIFER W ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1400 FOOTHILL DR, SUITE 100, SALT LAKE CITY, UT 84108-2327
(801) 664-2722
Mailing address
1083 DONNER WAY, SALT LAKE CITY, UT 84108-2506
(801) 664-2722
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6738811-1205
UT
207Q00000X
Family Medicine Physician
M-11240
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080151322
RR MEDICARE
AZ
05
—
487406
—
AZ
01
—
86080015085259C106
TRIWEST
AZ
01
—
86080015085260A076
TRIWEST
AZ
Enumeration date
11/28/2005
Last updated
03/30/2012
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