Individual
JODI LYN OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3133 E CEDAR PASS RD, EAGLE MOUNTAIN, UT 84005-4146
(435) 531-1066
Mailing address
3133 E CEDAR PASS RD, EAGLE MOUNTAIN, UT 84005-4146
(435) 531-1066
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6065166-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
6065166-8900
UT
Other
Enumeration date
08/28/2023
Last updated
10/03/2024
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