Individual
MRS. TAWNI LYNN JETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-0100
(801) 581-7676
Mailing address
PO BOX 413033, SALT LAKE CITY, UT 84141-3033
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5918471-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
591847-4405
APRN
UT
Enumeration date
12/16/2009
Last updated
10/21/2021
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