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Individual

JAQUELINE GASTELUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP-BC

Contact information

Practice address
476 N 900 W STE C, AMERICAN FORK, UT 84003-5202
(801) 492-1611
(801) 492-1480
Mailing address
10433 S REDWOOD RD STE 2, SOUTH JORDAN, UT 84095-8502
(801) 260-1919
(801) 260-1441

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
9708922-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
9708922-4405
UT

Other

Enumeration date
10/16/2024
Last updated
03/19/2025
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