Individual
JILL HENNINGFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 FOOTHILL BLVD, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
7692 S VILLAGE GLEN DR, WEST JORDAN, UT 84081-3607
(775) 934-7772
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AG10180058
UT
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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