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Individual

ALANNA BROOKE JORGENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
6360 S 3000 E STE 310, SALT LAKE CITY, UT 84121-6939
(801) 944-3144
Mailing address
6360 S 3000 E STE 220, SALT LAKE CITY, UT 84121-6924

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
13052546-1206
UT
390200000X
Student in an Organized Health Care Education/Training Program
UT

Other

Enumeration date
08/02/2022
Last updated
10/05/2022
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