Individual
JENNIFER ANN BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
920 N 500 W, PROVO, UT 84604-3339
(801) 374-1801
(801) 375-0369
Mailing address
920 N 500 W, PROVO, UT 84604-3339
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
355247-4405
UT
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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