Individual
JESSICA FECTEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
255 N 100 E, HYDE PARK, UT 84318-4009
(435) 535-6225
Mailing address
255 N 100 E, HYDE PARK, UT 84318-4009
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
8546238-3102
UT
207QA0505X
Adult Medicine Physician
Primary
85462384405
UT
Other
Enumeration date
04/05/2022
Last updated
05/05/2022
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