Individual
SHERRY A JACKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
(801) 322-3222
Mailing address
344 E 100 S, SALT LAKE CITY, UT 84111-1700
(801) 322-3222
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
N/A
UT
Enumeration date
02/02/2021
Last updated
03/11/2021
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