Individual
JENNIFER JEANINE ELLSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3401 N CENTER ST STE 175, LEHI, UT 84043-7502
(801) 893-1872
Mailing address
1756 W PARK AVE, RIVERTON, UT 84065-4701
(801) 893-1905
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12124921-4405
UT
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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