Individual
BECKY J JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5121 S COTTONWOOD ST, MURRAY, UT 84107-5701
(801) 507-7673
Mailing address
4778 W ELS CT, SOUTH JORDAN, UT 84009-1215
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
208109-3102
UT
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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