Individual
JESSICA HARLAND CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
36 S STATE ST FL 22, SALT LAKE CITY, UT 84111-1470
(801) 703-6721
Mailing address
5171 S COTTONWOOD ST STE 610, SALT LAKE CITY, UT 84107-5741
(801) 507-3630
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3214414405
UT
Other
Enumeration date
10/14/2022
Last updated
05/28/2023
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