Individual
MRS. JENNIFER MARY PANTELAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2511 S 800 E, SALT LAKE CITY, UT 84106-1728
(801) 486-1963
Mailing address
2511 S 800 E, SALT LAKE CITY, UT 84106-1728
(801) 486-1963
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7691455-4405
UT
Other
Enumeration date
07/18/2016
Last updated
11/10/2021
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