Individual
VICKI L JACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4624 HOLLADAY BLVD, SALT LAKE CITY, UT 84117-5206
(801) 277-2682
(801) 277-2980
Mailing address
4624 HOLLADAY BLVD, SALT LAKE CITY, UT 84117-5206
(801) 277-2682
(801) 277-2980
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
295232-4405
UT
Other
Enumeration date
05/23/2006
Last updated
10/21/2021
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