Individual
JENNIFER LAUREN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
585 N 500 W, PROVO, UT 84601-1548
(801) 374-1801
(012) 168-3578
Mailing address
838 W 2000 N, PROVO, UT 84604-1245
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
10226501
UT
Other
Enumeration date
06/25/2019
Last updated
09/03/2020
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